Health Net, a California Medicaid (Medi-Cal) plan, conducted a study of the success of its initiatives to improve member access, quality, and equity. The study authors concluded that virtual health initiatives were most important to achieving those aims. In preparation for the stateās new California Advancing and Innovating Medi-Cal (CalAIM) initiative, Health Net had analyzed a variety of its initiatives to improve member health equity and quality of care, identifying those with the most impact on members and subgroups of members.
For this report, four of the eight solutions Heath Net presented involved virtual delivery of services via telehealth, digital care management, and digital self-management. The four virtual health initiatives improved member access to care in different ways. In general, the initiatives gave members access to services at the start and height of the coronavirus disease 2019 (COVID-19) public health emergency in a way that simplified how members could access care, as follows:
- Telehealth capacity:Ā To rapidly expand telehealth capacity at the start of the COVID-19 public health emergency, Health Net awarded grants totaling $13.4 million to 138 of its Medi-Cal network provider organizations to expand their telehealth practices. By the end of the first year, 31% of these provider organizations were able to conduct routine check-ups or wellness checks via telehealth; 42% said telehealth was an important tool for health screenings. About 17% provided health education via telehealth; and 16% provided counseling and other mental health services using telehealth.
- Bright Heart HealthĀ managed medication assisted addiction treatment and pain disorders via telehealth services. During 2020, this program reduced participantsā use of high dose opioids and discontinued dangerous drug combinations by 30% to 40%. Emergency department and inpatient use by these members is still declining. The Bright Heart Health services reach consumers at home, without requiring that they enter a residential addiction treatment program.
- WellframeĀ provided a platform for Health Net members to text with care teams, and it provides day-to-day health information and educational content. It is intended to help members manage their health on their own between health care encounters. Maternity case managers offered Wellframe and 88% of people receiving maternity care used the app. The users rated the ease of communication through the app at 8.5 out of 10.
- Hazel HealthĀ received a $3 million grant from Health Net to launch operations for the 2021-2022 school year. Over 130 schools have implemented Hazel Health, and expansion is planned to reach a total of 200 K-12 schools. The Hazel Health services reduce disparities in access to services.
In the report, Health Net described each solution and provided examples of how each improved an aspect of access, quality, or equity. However, the report did not provide parallel data about access, quality, or equity before and after the solutions were implemented.
In addition to identifying the impact of virtual health initiatives, the analysis presented opportunities Health Net identified in its initiatives focused on gathering and analyzing accurate consumer data. Through these data initiatives, Health Net has been able to identify member subgroups experiencing disparities. The data initiatives were as follows:
- Gathering data:Ā Health Net has been collaborating with the California Department of Health Care Services (DHCS) on a $50 million, multi-year initiative to overcome the barriers to timely, complete, and accurate encounter data and inform real solutions. This initiative is called āEncounter Data Improvement Program.ā It targets Health Netās need for a more unified effort to clarify, standardize, and monitor the collection and reporting of encounter data statewide.
- Analyzing data to identify disparities in access and equity:Ā Health Net implemented a comprehensive Population Health Management (PHM) program that includes multiple teams from clinical pharmacy, care management, social work, medical management, and non-clinical resources to coordinate member care. The PHM program recognizes and incorporates disparities identified through the Health Equity Index Model to develop interventions to improve health outcomes. Equipped with the PHM data, Health Net provides members with education care coordination and support.
These strategies were reported in āInnovating Within Medi-Cal; Key Findings & Recommendations To Improve Access To Quality Care & Drive Health Equity.ā by Health Net. In the report, Health Net described its approach to designing community-based initiatives intended to improve access to care and better health outcomes for its members. Since 2017, Health Net has invested more than $100 million to support more than 500 innovative community-based initiatives.
CalAIM is the stateās plan to transform and strengthen Medicaid services by using a more coordinated, person-centered approach to service delivery. The Centers for Medicare & Medicaid Services (CMS) approved the CalAIM waiver amendment on December 29, 2021, effective January 1, 2022, through December 31, 2026.
The full text of āInnovating Within Medi-Calā was published in May 2022 by Health Net. A free copy is available online at https://bridgingthedivideca.com/wp-content/uploads/2022/05/Innovating-Within-Medi-Cal-Report.pdf (accessed June 24, 2022).
OPEN MINDS last reported on Health Netās California initiatives in āHealth Net Awards More Than $4.5 Million In Grants To 78 California Community-Based Organizations Serving Populations With Low COVID Vaccination Rates,ā which published on March 1, 2022. The article is available at https://openminds.com/market-intelligence/bulletins/health-net-awards-more-than-4-5-million-in-grants-to-78-california-community-based-organizations-serving-populations-with-low-covid-vaccination-rates/.
For more information, contact: Michelle JelaÄiÄ, Public Relations & Media Specialist, Health Net, 4201 East Commerce Way, Sacramento, California 95834; Email: MediaInquiries@healthnet.com; Website: https://www.healthnet.com/