A Note from the CQC Senior Director

​Reflecting on the past year, we have all been challenged to our limits and beyond, and California’s health delivery system has stepped up to test, vaccinate and care for our communities. To continue the support for our shared delivery system, CQC has catalyzed systematic change that will enable practices to deliver the care patients need and purchasers expect as we continue to navigate COVID-19 and beyond.

This month’s newsletter shares bright spots from our work across California during this past year. 

CQC Impact Report

See how we have impacted the health delivery system this year in the 2021 CQC Impact Report. Our efforts are furthering advanced primary care, accelerating behavioral health integration into primary care practices and improving access and outcomes of care delivered through telehealth.

Together, CQC’s team, sponsors, committee members and participants have:

• Developed a set of practice-level quality measures aligned and endorsed statewide to define advanced primary care.
   
• Designed a statewide pilot for implementation in 2022 of the advanced primary care measure set with adoption by California Public Employees’ Retirement System (CalPERS), Covered California, the San Francisco Health Service System and eBay.
   
• Improved the care and experience among 720,000 Californians with diabetes and asthma through the CalHIVE Network’s technical assistance, resulting in expanded telehealth use to close care gaps and to pilot innovative care solutions, such as remote patient monitoring and mobile health clinics.

CalHIVE: Strengthening Telehealth in 2021

As the first year of CalHIVE, CQC's improvement collaborative supporting provider organizations with virtual care for chronic condition management, comes to an end, participating provider organizations have engaged in 90 hours of one-to-one consultation and 40 hours of peer learning events with CQC improvement and data advisors.

Through the support of CalHIVE, these organizations have demonstrated organizational improvements in key areas for telehealth and effective primary care. Demonstrated improvements included:

• Adoption of defined strategies to sustain telehealth services for chronic disease care and monitor services for quality and equity;
• Implementing workflows to close care gaps through systematic sharing of reports and follow-up processes.

In 2022, CalHIVE teams will continue to receive individualized improvement coaching including onsite visits, learning events starting with population health management and data analysis and trends.

CalHIVE Spotlight: Desert Oasis Healthcare (DOHC)

Desert Oasis Healthcare (DOHC) is a participating provider organization of CQC’s CalHIVE Network. They are an Independent Physician Association and medical group, serves communities living in the Coachella Valley and Morongo Basin across Riverside and San Bernardino counties. After recognizing that not all in the communities they serve were benefiting from expanded access to care through telehealth, DOHC launched a mobile health unit in the spring of 2021 with CalHIVE support.

Supported by the DOHC pharmacy team, the mobile health unit has predominately been used to offer access to care at large local employers where working hours and transportation have historically prohibited in-person office care during normal business hours.

• The unit provides access to a care team on-site, or patients can speak directly to their physician via the unit’s virtual exam room.
   
• Patients with diabetes can also enroll in remote patient monitoring programs and receive glucometers and other necessary devices.
   
• DOHC’s efforts to better center patients has helped improve satisfaction and quality of care while expanding the reach of their virtual tools.

Measuring Advanced Primary Care in California Practices

CQC has defined a shared standard for advanced primary care, including a set of common attributes, defined from the patient’s perspective.  The attributes outline what patients can expect from providers and practices delivering advanced primary care, as well as a complementary measure set used to identify clinical practices delivering advanced primary care.

Thanks to the support of the California Health Care Foundation, CQC and Integrated Healthcare Association will launch a statewide pilot of the measure set for practice-level performance on January 1, 2022 to apply this work across California’s primary care delivery system.

Covered California, CalPERS, the City and County of San Francisco and eBay have announced their participation in the pilot. Initial results from the pilot will be available in the summer 2023.

The pilot aims to:

• Identify primary care practices delivering advanced primary care and understand what differentiates them from those who do not.
• Understand the ability of our current data infrastructure to readily identify and attribute performance data to assess practice performance.
• Highlight disparities in access to advanced primary care across California’s diverse population.
• Apply learnings to future iterations of the pilot and inform development/application within alternative payment mechanisms.
• Promote a shift away from process-based assessment and measures of practice performance to a system based on outcomes and experience of care.

Partner Resources

• A new white paper by Manatt Health, ‘Supporting the Future of Primary Care in California Through Aligned Hybrid Payment Models,’ makes the case for widespread adoption of “hybrid” payment models as an immediate action to support primary care’s future in California. It calls on California payers and purchasers to work together on implementation through strong coalitions that have already been established by CQC, the Integrated Healthcare Association and others.