Introduction
Healthcare reform has been a major topic for the past 5 years and remains a challenge for both state and federal governments. In 2014, the Affordable Care Act (ACA) was fully implemented, becoming the most extensive healthcare reform policy to date (Los Angeles County Department of Mental Health [LACDMH], n.d.). While much debate has centered around whether the ACA would actually improve health care, the policy was created to accomplish three things: (1.) improve the quality of care amongst patients, (2.) improve the overall health of the general population and (3.) minimize the cost associated with health care (LACDMH, n.d.). Because the ACA left the implementation of these reforms to the state, each state has taken their own individual steps to implement policies best fit for their residents. Of the 50 states, California has been one that continuously focuses on improving health care for their citizens. Over that past years, California has tackled issues from premium costs and insurance exchange standards to ambulatory services (California Health Care Foundation [CHCF], 2016). This paper addresses the current initiatives taken by California to implement health care reform policies and how these initiatives have benefited their residents.
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"Healthcare Reform: California’s Initiatives in Healthcare Reform".
California Healthcare Reform Initiatives
Since the introduction of the ACA in 2012, California has rigorously worked to reform the state of healthcare and have continued these initiatives long after the ACA has passed. Initially, California focused on increasing the insured population by expanding Medi-Cal and opening Covered California, California’s version of their insurance exchange (CHCF, 2016). In addition to expanding both Medi-Cal and Covered California, California has also implemented initiatives revolving around the integration of health care systems, reducing the cost of health care, consolidating services, developing new health care practice models, hospital readmissions and ambulatory care (CHCF, 2017).
How Has Healthcare Reform Initiatives Benefited Residents?
To increase the insured population in California, officials focused on changing the eligibility requirements for Medi-Cal. Increasing the insured population through Medi-Cal was done by allowing wider range of adults increasing the they income threshold needed to qualify (LACDMH, n.d.). Because of these provisions, the number of insured individuals under Medi-Cal increased to approximately 10.3 million from 6.8 million, although these numbers include those that have partial coverage from other managed plans (CHCF, 2017). At the end of 2015, California only 8% of its population not covered by health insurance (CHCF, 2017).
Patient satisfaction and quality of care have also increased since the healthcare initiatives implemented by California. Improvement of these factors were based on practice models developed through the collaboration between health organizations, state/local government agencies and private insurers. These partnerships directly addressed needs such as expensive ambulatory services, the integration of health care systems, reducing the cost of services in some areas and addressing issues in the hospital settings (CHCF, 2016). Between 2010 and 2015, patients’ opinions on health care and quality have increased. For instance, based on a survey conducted by the Consumer Assessment of Healthcare Providers and Systems, satisfaction and quality of care was nearly at 50% for both HMO and PPO plan holders (CHCF, 2017). However, certain aspects of care ranked higher than others. Patients expressed more satisfaction regarding coordination of care, doctor communication, access to care and shared decision-making (CHCF, 2017).
Economic Factors
Overall, the implementation of healthcare reform in California has profited insurers and driven healthcare spending tremendously. Before the implementation of healthcare initiatives, the health insurance business in California was valued at $122.9 billion, however, after the implementation of the initiatives previously mentioned, the value jumped to $162.5 billion (CHCF, 2017). Although revenues amongst insurers have increased, the overall spending in California has nearly tripled those amounts. In 2016, spending grew tremendously to more than $367 billion (Sorenseen, Nonzee & Kominski, 2016). Interestingly, only 29% of expenditures were from private health care (Sorenseen et al., 2016). Public health care accounted for a large majority of health care spending, further demonstrating the vast expansion of Medi-Cal that has taken place.
Conclusion
California has taken healthcare reform for their citizens very seriously. Initiatives to improve healthcare has reached far beyond expanding public health care assistance. Government officials in California have taken steps to improve the quality of care for patients by partnering with health organizations and insurers to develop and implement innovative programs and practice models for healthcare professionals. These initiatives revolved around solving issues that dealt with the cost of care, hospital readmissions, consolidating services and integrating health care systems. Moreover, these initiatives have greatly increased the value of the health insurance industry as well as the state’s health care spending.
