Largest Physician Quality Improvement Initiative in California History Yields Huge Health Benefit for Patients, $345 Million in Savings

9,800 California providers work together to improve health for 5.9 million Californians, saving $6 for every $1 invested

BURBANK, Calif., Aug. 21, 2019 /PRNewswire/ -- State leaders, health plans, and provider organizations met today for the California Transformation Summit to announce major results of the largest collaborative initiative in history to improve health care quality, and discuss next steps.

With more than $52 million in grants from the Centers for Medicare and Medicaid Services (CMS) under its Transforming Clinic Practice Initiative, the Pacific Business Group on Health (PBGH), L.A. Care Health Plan, and the Southwest Pediatric Practice Transformation Network (a partnership of Children’s Hospital of Orange County and Rady Children’s Hospital) served as three practice transformation networks. They worked with 9,800 California physicians serving 5.9 million patients over four years as part of the largest quality improvement effort ever underway in the state. The overall goals of the CMS-supported effort were to improve quality of patient care and spend health care dollars more wisely.

This is a collaborative peer-based learning initiative that offers dedicated coaching and technical support to achieve its goals. The results of this initiative, conducted over four years, show:

• $345 million in cost avoidance, $6 saved for every $1 invested
• 67,000 avoided emergency department visits
• 57,000 avoided hospital admissions
• 750,000 patients with improved health outcomes (e.g. diabetes, hypertension, asthma) or improved processes of care (e.g. treated using new and improved clinical guidelines)

“This effort shows that proactively investing in high-quality care and care coordination brings value to patients, providers, payers, and the overall system. Helping primary care practices transform is both achievable and important. We need to continue to collaborate and scale investment in multi-payer support for advanced primary care,” says Dr. Michael Weiss, Vice President, Population Health, CHOC Children’s.

Leaders participating in the summit included: Elizabeth Mitchell, CEO, Pacific Business Group on Health; John Baackes, CEO, L.A. Care Health Plan; Peter Lee, Executive Director, Covered California; Mary Watanabe, Acting Chief Deputy Director of Department of Managed Health Care; and Peter Long, SVP, Health Care and Community Transformation, Blue Shield of California. They discussed how to leverage the success of the initiative and ways to foster further state transformation efforts.

“We hope this helps the state of California recognize the value of non-traditional services, including community-based support. Health is determined by far more than medical care and to meet a person’s needs, a physician and care team may need to spend time to help figure out housing and transportation outside of the clinic walls,” says John Baackes, CEO of L.A. Care Health Plan.

“The lesson for employers and others who pay for care – including the state of California – is that primary care is the right investment. For employers, this not only reduces their total health care spend but improves health outcomes for employees and their families,” says Elizabeth Mitchell, CEO of PBGH. “This works, and it’s a win-win.”

Leaders emphasized the need for multi-payer alignment, measure alignment, and a stronger focus on recognizing and rewarding high performing practices.

“At a time when there are very few success stories in health care, this effort is truly an amazing accomplishment,” says Mitchell. “When committed and talented people come together across regional geographies and sectors, we can support health care providers to provide great care and avoid costs. Washington, DC, should be taking note.”

About PBGH/California Quality Collaborative
Pacific Business Group on Health is an action-oriented 501c(3) non-profit organization focused on improving health outcomes, experience and affordability for consumers and purchasers across the United States. Since 1989, PBGH has distinguished itself as a national innovator driven by some of the largest and most influential public and private purchasers of healthcare in the country. Housed at PBGH, California Quality Collaborative (CQC) is a health care improvement organization dedicated to advancing the quality and efficiency of the health care delivery system in California. CQC creates scalable, measurable improvement in the care delivery system important to patients, purchasers, providers and health plans.

About CHOC Children’s
Affiliated with the University of California, Irvine, CHOC Children’s regional pediatric healthcare system includes a 334-bed hospital in Orange, a 54-bed hospital in Mission Viejo, an inpatient mental health center, and expansive outpatient primary and specialty care services. To learn more, visit choc.org.

About L.A. Care Health Plan
L.A. Care Health Plan serves nearly 2.2 million members in Los Angeles County, making it the largest publicly-operated health plan in the country. L.A. Care offers four health coverage plans including Medi-Cal, L.A. Care Covered™, L.A. Care Cal MediConnect Plan and the PASC-SEIU Homecare Workers Health Care Plan, all dedicated to being accountable and responsive to members. As a public entity, L.A. Care’s mission is to provide access to quality health care for L.A. County’s vulnerable and low-income communities, and to support the safety net required to achieve that purpose. L.A. Care prioritizes quality, access and inclusion, elevating health care for all of L.A. County. For more information, follow us on Twitter, Facebook, LinkedIn, and Instagram.

This project was supported by Funding Opportunity Number CMS-1L1-15-003 from the U.S. Department of Health & Human Services, Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

Contact: Nicole Perelman, 415-385-2283

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SOURCE Pacific Business Group on Health