Population Health and Medi-Cal 2020: Gathering disparate systems under a single banner

As the industry moves away from fee-for-service and towards holistic care, strategies under the umbrella of “Whole Person Care” will become important for systems wanting to maximize outcomes.

I attended the National Association of Health Service Executives (NAHSE) Annual Meeting in Las Vegas, and perhaps the most valuable session was focused on California’s Medi-Cal waiver and it’s constituent programs such as PRIME and Whole Person Care (WPC). The presenters were Whitney T. Evans of Lourdes Hospital (New York), Warren Lyons from Health Management Associates, and Aisha Williams from ADW Associates.

WPC is just one aspect of the Medi-Cal 2020 program, but it may have an outsize impact on preventative care, according to the panel.

The main thrust of WPC is multi-disciplinary care coordination, with open lines of communication between primary care, behavioral health, and social service providers. Instead of treating the uninsured with costly emergency department visits, Medi-Cal will provide support to integrate care for high-risk Medicare beneficiaries. Coordination of otherwise siloed services will improve care for dual-eligibles who have historically poor outcomes due to the amount of services they require.

Targeted populations include patients at a risk of homelessness or people with medical needs for housing or other home support services.

 Other goals of Medi-Cal include a move towards Alternate Payment Models (APM) and the Public Hospital Redesign and Incentives in Medi-Cal Program (PRIME).

 Read about the initiatives comprising Medi-Cal 2020 at the official webpage.