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In the Nick of Time: Federal Reform and California’s Healthcare Delivery System

In the Nick of Time: Federal Reform and California’s Healthcare Delivery System. Micah Weinberg Senior Research Fellow, California Program. All you wanted to know about California …. Distinct regional markets and delivery systems Homeland and hotbed of care integration

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In the Nick of Time: Federal Reform and California’s Healthcare Delivery System

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  1. In the Nick of Time:Federal Reform and California’s Healthcare Delivery System Micah Weinberg Senior Research Fellow, California Program

  2. All you wanted to know about California … • Distinct regional markets and delivery systems • Homeland and hotbed of care integration • Kaiser, delegated model, IHA • But managed care eroding (down 7% ’02-’08) • Care integration hasn’t controlled costs • Hospital prices now rising at twice national average • Growing provider clout foreshadows challenge • $20 billion state budget deficit • Dysfunctional government, future looks even more grim

  3. “One truly scary thing about health reform: far from being a government takeover, it counts on local communities and clinicians for success.” - Dr. Atul Gawande

  4. Projects with promise • California Task Force on Affordable Care • Partnership between Blue Shield, Hill Physicians, Catholic Healthcare West for CalPERS • Integrated Healthcare Association – Plan for Bundled Knee and Hip Replacement with Cedars Sinai, Blue Shield, others • Medi-Cal Waiver process promoting care integration in public programs

  5. Preserving the CA Safety Net? • Uncertainty with state budget • “Medical Home”: Federal Government to Cover 90% of cost for Medicaid Beneficiaries with Chronic Illnesses who are in a Medical Home • New Payments to Federally-Funded Clinics: $12.5 billion (up from ~ 2 billion) in Legislation • Rural Safety Net Hospitals: Helped with New Federal Payments

  6. To the extent that federal reform creates a marketplace that rewards value, it builds on the best parts of the California delivery system …and does so just in the nick of time. Micah Weinberg weinberg@newamerica.net(916) 706-2664

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