Title
Receive a presentation from the County's Natividad Medical Center and Health Department staff on Medi-Cal 2020: the five year renewal of California's Section 1115 Medicaid Waiver.
Report
RECOMMENDATION:
It is recommended the Board of Supervisors:
Receive a presentation from the County's Natividad Medical Center and Health Department staff on Medi-Cal 2020: the five year renewal of California's Section 1115 Medicaid Waiver.
SUMMARY/DISCUSSION:
Section 1115 of the Social Security Act allows states to waive certain federal statutory Medicaid program requirements or obtain federal matching funds for costs or investments that would not otherwise be allowed under the Medicaid program. This flexibility allows states to test innovative approaches to care, in an effort to improve quality, access and efficiency.
On December 30, 2015, the federal Centers for Medicaid and Medicare Services (CMS) approved Medi-Cal 2020 - a five year renewal of California's Section 1115 Medicaid Waiver, which will continue to provide to California's Public Safety Net Providers with more than $6.2 billion in federal funding through various programs.
The County is participating in three of the four programs of the 2020 Medi-Cal Waiver: PRIME, Global Payment Program, and Whole Person Care.
Public Hospital Redesign and Incentives in Medi-Cal (PRIME) is a pay-for-performance program in which California's public health care systems and District and Municipal Hospitals are using evidence-based quality improvement methods to achieve ambitious performance targets and improve health outcomes for patients. All federal funding for this program is contingent on meeting these targets and demonstrating continued improvement.
The Global Payment Program (GPP) is the first payment reform effort aimed at encouraging primary and preventive care. Despite the progress made under the Affordable Care Act, the UC Berkeley Center for Labor Research and Education estimates that by the year 2019, thre...
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