California’s Whole Person Care Pilot Program

Harbage Consulting released a report on California’s new initiative, the Whole Person Care (WPC) Pilot program, which was launched in November 2016.

The WPC program was authorized through California’s section 1115 waiver, Medi-Cal 2020 and will coordinate health, behavioral health, and social services to improve Medi-Cal beneficiaries’ health outcomes. No other states have implemented Whole Person Care programs.

“California has often been a leader in testing new approaches to health care delivery, and the Whole Person Care Pilots are a truly innovative strategy for using the Medicaid 1115 waiver authority to address the social determinants of health,” said Jennifer Ryan, Vice President at Harbage Consulting, in a press release.

18 pilot applications were approved by the DHCS across the state. The majority of the pilots are county agencies.

Almost 300,000 beneficiaries are expected to benefit from the pilot.

The WPC program will focus on supporting the homeless population, enhancing care coordination, and sharing patient data across providers. The target population is high utilizers, individuals who are homeless, individuals with mental health or substance use disorder conditions, and individuals who have recently been released from institutions.

While each pilot is implementing different programs based on community need, all are required to expand their existing data sharing frameworks. They must work with their partner MCPs with data collection and sharing capabilities.

The program has up to $3 billion in funding, half from federal Medicaid matching funds. The program is scheduled to run for five years, with pilots receiving payment based on their achieved metrics.

The participating pilots are

  • Alameda County Health Care Services Agency
  • Contra Costa Health Services
  • Kern Medical Center
  • Los Angeles County Department of Health Services
  • Monterey County Health Department
  • Napa County
  • Orange County Health Care Agency
  • Placer County Health & Human Services Department
  • Riverside University Health System Behavioral Health
  • San Bernardino County Arrowhead Regional Medical Center
  • San Diego County Health & Human Services Agency
  • San Francisco Department of Public Health
  • San Joaquin County Health Care Services Agency
  • San Mateo County Health System
  • Santa Clara Valley Health & Hospital System
  • Shasta County Health & Human Services Agency
  • Solano County Health & Social Services
  • Ventura County Health Care Agency