Through the Section 1115 Medicaid Waiver, a five-year agreement between the State and the Obama administration that began in November 2010, public hospital systems are expanding coverage to uninsured adults and transforming the delivery of care in advance of national health reform, when an estimated 4.5 million Californians will gain access to health care coverage.
Specifically, the Waiver includes several components that are helping public hospital systems prepare for and implement health reform in 2014:
- The Low Income Health Program, an effort to enroll hundreds of thousands of low income uninsured adults in a comprehensive health coverage program
- The Delivery System Reform Incentive Program, a pay-for-performance initiative that challenges public hospital systems to meet specific benchmarks related to improving health care access, quality and safety and outcomes
- A mandatory shift of 380,000 Seniors and Persons with Disabilities (SPDs) into Medicaid managed care, which will improve access to quality health care services and care coordination
To read more information on the Section 1115 Medicaid Waiver please click here
Section 1115 Medicaid Waiver
California’s Section 1115 Medicaid Waiver, titled the “Bridge to Health Care Reform”, is a five year plan that has the potential to bring in $10 billion in federal funding in order to among other things help California’s public hospital systems prepare for and implement health reform. The Waiver is intended to help sustain the state’s Medicaid program (known as Medi-Cal), test new innovations to help improve care and reduce costs, and support the safety net in advance of health reform. For California’s public hospital systems, the Waiver also serves as a major source of core funding to partially offset the costs of treating a large uninsured and Medi-Cal population.
In order to prepare for the increased demand for health care services, public hospital systems are making significant improvements to their delivery systems to improve efficiencies, coordination, quality and safety. As a bridge to health reform, the Waiver provides an opportunity for public hospital systems to expand coverage early to hundreds of thousands of low-income families so they can begin receiving the preventive care they need through a team of providers that are proactively working to improve health outcomes. Furthermore, public hospital systems are working on multiple system-wide improvement projects to strengthen the way care is delivered to make it more streamlined and patient-centered so that patients receive the right care at the right time in the right place.
Please see the following material for more information on the Waiver and related topics: