Notably, the state’s major health care purchasers who are part of the PICG have committed to advance these shared principles and recommended actions within their organizations, which provide health coverage for 16 million Californians. A new analysis released alongside this study on commercial health plans and provider organizations shows such a commitment is unique to California, which is well positioned to join 17 other states engaged in shifting more health care system resources to primary care.
Starting this year, CalPERS is requiring PPOs to match members with primary care providers to improve care quality while reducing care costs. Starting next year, Covered California will require health plans to measure and report primary care spending. Starting in 2024, the Department of Health Care Services is tying payments to health plans serving Medi-Cal managed care to quality and equity measures, and plans will be required to report on their primary care spending (PDF).
“Covered California has always prioritized primary care, as it’s clear patient-focused care teams matter to health care quality, equity, and patient experience,” said Alice Hm Chen, Covered California’s chief medical officer. “This study shows California is ready to transform care through increased investment in primary care, and provides a new impetus to act.”
“Increased investment and focus on primary care has the potential to provide more coordinated, cost-effective, and quality care for millions of California consumers,” said Anthony Wright, executive director of Health Access California, the statewide health care consumer advocacy coalition. “An insurance card is necessary but not sufficient: Patients need a primary care provider, one who proactively prioritizes prevention upfront, and who can guide them through the health challenges they end up facing, through our complex health care system of different specialists and treatments.”
About the California Health Care Foundation
The California Health Care Foundation is dedicated to advancing meaningful, measurable improvements in the way the health care delivery system provides care to the people of California, particularly those with low incomes and those whose needs are not well served by the status quo. We work to ensure that people have access to the care they need, when they need it, at a price they can afford.
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