Happy New Year and welcome to the SNI Forward, our quarterly snapshot of the transformation progress at California’s public health care systems and the work of the California Health Care Safety Net Institute (SNI).

January is an opportunity for us to catch our breath after hosting the CAPH/SNI Annual Conference. This year’s theme, “Our Enduring Mission,” recognized the historic role public health care systems play in providing high-quality care to all Californians, which continues to this day. We recognized several members at the Quality Leaders Awards for their excellent efforts to address the social determinants of health, listened to inspiring speakers, and reflected on our journey toward population health and value-based care.

Looking back on 2018, SNI continued our mission of supporting members by informing health policy, providing performance measurement expertise, and crafting learning opportunities. Last year, we hosted nine in-person meetings for over 800 attendees and 52 webinars for over 2,000 attendees, bringing together members and key partners for discussion on topics like data sharing, value-based care readiness, and behavioral health integration.

The public health care systems also completed year three of the PRIME program – an ambitious five year pay-for-performance initiative, which helps members delve deeper into value-based care and improve quality for patients. At our recent PRIME webinar, two members, Alameda Health System and Riverside University Health System, reminded us of the human element of quality improvement – for staff as well as patients. We’re pleased to be able to share this impactful data as well as the story behind the transformation.

Giovanna Giuliani
Executive Director
California Health Care Safety Net Institute

Program Highlight

Member Collaboration: Supporting PRIME and QIP

In October, SNI hosted our ninth Waiver Integration Team (WIT), bringing together over 90 interdisciplinary clinical, operational, and data leaders to discuss shared successes and common challenges based on the third year of PRIME data. The WIT also focused on reporting for the first year of the Quality Incentive Program (QIP).

Several members provided on-the-ground experiences with PRIME program implementation. The Los Angeles County Department of Health Services and University of California San Francisco shared key initiatives from their post-acute transition programs. A range of strategies was discussed that includes automated phone outreach, building post-acute care collaborations, discharge checklists, and partnerships with patient-centered medial homes. San Francisco Health Network also presented on their primary care-specialty care collaboration effort, which aims to strengthen coordination between primary and specialty care with tactics such as consultative guidelines and shared quality metrics.

The day ended with round-table discussions on gathering data, engaging providers, improving depression screening, aligning quality reporting, and pain management. Members left with new ideas and peer connections to implement at their home organizations

By the Numbers

PRIME Year Three Results: Improving Quality

In September, PRIME entities submitted program year three data.* Overall, CAPH/SNI members continued to demonstrate high performance for existing measures with new challenging targets, while incorporating an additional 27 pay-for-performance (P4P) metrics. Members met 89% of their P4P targets and 93% of all metrics (including pay-for-reporting metrics and innovative metrics without established benchmarks yet).

The PRIME metrics are intentionally wide-reaching and require a number of care delivery improvements such as increased screening rates, behavioral and primary care coordination, and enhanced care transition processes. With three years of data compiled, we can see the demonstrated impact of PRIME on the lives of patients.

Learn more about PRIME performance, patient impact, and member system perspectives with our recent publication, Value-based Care in Medi-Cal, or listen to the December PRIME webinar.

Member Highlights

Quality Leaders Awards

Each year at the CAPH/SNI Annual Conference, we celebrate the Quality Leaders Awards, where members are recognized for their outstanding efforts to provide high-quality, efficient, equitable, and patient-centered care. Learn more about the outstanding 2018 winners through their video submissions:

Top Honor

Los Angeles County-USC (LAC+USC) Medical Center

To better meet the needs of patients and improve health outcomes, the primary care adult clinics at Los Angeles County-USC (LAC+USC) Medical Center implemented an integrated behavioral health and social services program into primary care clinics to improve access to behavioral, mental, and social services.

Performance Excellence

Zuckerberg San Francisco General Hospital and San Francisco Health Network
 A large multidisciplinary team from Zuckerberg San Francisco General Hospital (ZSFG) and San Francisco Health Network (SFHN) initiated a novel approach to deliver holistic care to Emergency Department (ED) patients with complex social needs, ranging from a new ED social medicine consult service to direct linkage for ED patients to transitional housing.

Data-Driven Organizations

Contra Costa Health Services
Contra Costa Health Services (CCHS) leveraged their well-established electronic health record (EHR) system to improve care coordination across county departments and provide more integrated services to patients by developing Patient 360 — a single, electronic care platform enabling CCHS staff and providers to view critical patient information.

Ambulatory Care Redesign

Ventura County Health Care Agency
To address practical barriers homeless patients often experience while accessing services, Ventura County Health Care Agency (VCHCA) developed mobile “one stop” outreach and service events, which include a mobile shower unit co-located alongside medical, behavioral health, and social services.

What’s Next

Innovative Metrics in PRIME – This January, SNI will be sharing innovative metric progress in PRIME at the 2019 CMS Annual Quality Conference.

Data for Population Health – On February 7, SNI will convene data and population health leaders to identify solutions to implement and optimize data analytics that support population health and value-based care, including opportunities to strengthen data governance and workforce capacity.

Whole Person Care – This spring, in partnership with the Department of Health Care Services (DHCS) Learning Collaborative, SNI will help pilots develop and strengthen their transitional care and housing supportive services.

Reporting Expertise & Analysis – SNI continues to provide reporting expertise and performance analysis for the waiver and managed care rule reporting deadlines, including Whole Person Care (January 31), Global Payment Program (March 31) and PRIME (March 31).

Learn More

Visit our website at www.safetynetinstitute.org or follow SNI news on Twitter @CAPHSystems. CAPH/SNI members can access program materials through SNI Link– our members’ only program portal.