Transcript ACA Readiness Project - Merced County, California

ACA Readiness Project
Presented to the
Merced County
Health Care Consortium
October 23, 2014
Kathleen Grassi, R.D., M.P.H.
Merced County
Department of Public Health
ACA Readiness Project
2013 Public Health Department funded by:
 The California Endowment,
Building Healthy Communities, Merced
 Blue Shield of California Foundation
In neighborhoods, in schools and
with prevention.
Affordable Care Act
• Federal legislation signed into law in 2010
• ACA Triple Aim Goals:
 Improve
health care delivery;
 Improve
the health of populations; and
 Reduce
health care costs.
Why is the ACA Important?
Too many people
lack health
coverage & care
System focuses on
treatment instead
of prevention
U.S. healthcare
spending is
unsustainable
Inefficient
delivery and
payment system
Low-ranking U.S.
health outcomes
ACA Components
ACA Readiness Project
Project Goals:
• Increase health care access through
coordination of enrollment opportunities
• Assess local health care provider capacity
• Plan for service integration within and
across health care institutions
Why Health Care Coverage?
Merced County Estimated Uninsured and
Projected Coverage Eligibility (prior to January 2014)
60,000
Ineligible Due to Documentation Status
50,000
8,750
40,000
30,000
4,400
18,850
0
Covered CA – Subsidy
Medi-Cal
20,000
10,000
Covered CA – No Subsidy
18,700
Uninsured Coverage Eligibility
Source: Pacific Health Consulting Group. Early Returns: First Year Covered California and Expanded
Medi-Cal Enrollment Trends in Merced County, September 2014.
Medi-Cal Enrollment Results
New Medi-Cal Enrollment in Merced County
January 1 – June 30, 2014
20,000
3,159
16,000
Adult Expansion MC
12,000
8,000
13,805
4,000
0
Pending MC Applications
2,243
New Medi-Cal Enrollment
Non-Expansion MC
Covered California Enrollment
Covered California Enrollment Characteristics
Merced County
(N=8,403)
California
94%
88%
Less than 18
4%
6%
18 to 25
13%
12%
26 to 34
16%
17%
35 to 44
18%
17%
45 to 54
26%
24%
55 to 64
24%
24%
41%
28%
Subsidy Eligibility
Eligible for Subsidies
Age
Ethnicity
Latino/Hispanic
Source: Covered California
October 2013 to April 2014
Health Care Services
• Sufficient primary care capacity currently
• Insufficient specialty care capacity historically
• Integration of care, especially PC/BH
• Development of prevention services
Project Deliverables
• Expanded Health Care Consortium
• Regular Informational Meetings
• Coordinated Outreach and Enrollment Efforts
• Development of Policy Briefs
• Harness the Momentum: From Care to
Coverage Summit
Innovations
• Chronic Disease Self-Management
• “Now that I have coverage….”
• Integration across systems
• Health Information Exchange
Contribution to Premature Death
2002
•
•
•
•
Social circumstances 21%
Environmental exposures 7%
Behavioral patterns 57%
Medical care 14%
2007
Adapted from: McGinnis JM, Williams‐Russo P, Knickman JR.
“ The case for more active policy attention to health promotion”. Health Affairs
Health Impact Pyramid
Source: Frieden, T. A Framework for Public Heath Action: The Health Impact Pyramid. Am J Public Health. 2010; April; 100(4): 590–595.
Partnerships to Improve Community Health
Public Health Strategies
Reduce
Exposure to
Tobacco and
Second-hand
Smoke
Increase
Healthy Food
Options
Create
Physical
Activity
Opportunity
Expand Access
to Chronic
Disease
Prevention
resources
Evaluation
Measure the Impact of Public Health Strategies
Communication
Educate and Inform
The Public, Partners and Policy–makers
Partnerships
Work together with residents, community and faith-based
organizations, schools, agencies, and local government
to create health promoting environments where we
live, work, and play
ACA Readiness Project
Thank you