5 Things California: Hospital payments, Primary care, Long term care

With three and a half weeks to go before our 2019 Northern California State of Reform Health Policy Conference, we are putting the final touches on our list of more than 65 speakers. And, since those folks are working on the issues that we are all watching in California health care, we wanted to feature some of the panels, thought leaders, and topics you’ll see next month at State of Reform in Sacramento.




With help from Marjie High


1. Long term care takes center stage

Governor Gavin Newsom has made preparing for the bolus of retirees hitting the long term care system a centerpiece of his health policy agenda. To help him develop that vision and put policy in place to support it, he has brought on one of Sacramento’s most trusted and respected policy thinkers: Rich “Fig” Figueroa.

At State of Reform, Fig will be joined by one of California’s most prominent long term care policy makers, Asm. Adrin Nazarian who serves as Chair of the Aging and Long Term Care Committee in the Assembly. Sarah Steenhausen will round out the panel, with her years of experience bridging the market and policy conversations at the SCAN Foundation.

2. Envisioning the future of primary care

In an age of value based payments, social determinants of health, and tele-medicine, the role of primary care is in flux. Moreover, attracting and retaining primary care providers to meet California’s market demand is proving difficult. So, where does the market and public policy come together to re-think our approach to primary care?

L. Gordon Moore, MD, the Senior Medical Director of Population & Payment Systems at 3M Health Information Systems, will be joined by Helen DuPlessis, MD, Principal at Health Management Associates, and Jonathan Porteus, PhD, Executive Director of area FQHC WellSpace Health. Together, they will talk through the needs, challenges, and innovations set to impact primary care provision in California and new visions for the health care system moving into the future.

3. Building a business case for the social determinants

With the connection between behavioral health and physical health increasingly clear, how are health plans and systems factoring social determinants into their approach to care? From Medicare to county-led initiatives, a business case is increasingly applied to this challenge in ways that are starting to re-shape care.

We have assembled three of the most thoughtful minds we know on the subject. Tanya Dansky, MD, is the Chief Medical Officer at Promise Health Plan. She will be joined by Holly Harper, Director of External Affairs at Sutter Health, and Kelly Bennett, CEO of Covered Sacramento. The three will connect the dots between what they know about SDOH and how that knowledge can impact the bottom line.

4. Changing the way hospitals are paid

It’s clear that most of the money in health care is spent in the hospital setting. However, with a broad range of hospital types and with circumstances varying by geography, payer mix, etc., a “one size fits all” model to manage this spend is difficult to reach. What works for one hospital may not work for another.

This session includes some very thoughtful executives that spend considerable time on this topic. Anne McLeod, SVP at CHA, and Ann Boynton, Director of Payer Strategies at UC Davis, will anchor this panel, bringing a wealth of knowledge from their careers. Michelle Lopes, SVP at John Muir, is invited to round out the panel.


5. Is it time to re-think the rationale of network adequacy?

With technology increasingly supplanting the traditional patient-provider relationship, an increasingly relevant policy question has arisen: Has the modern market moved past the traditional model of network adequacy? If a plan can provide access to providers virtually, does that change the need for providers locally?

It’s an interesting question. Whether or not the time is right now to make this policy change, it’s clear that market trends will continue to raise this question in the future. Lisa Chan-SawinMelissa Borrelli, and Paul Giboney will take up this question and talk through the policy implications of the market’s innovations.