Michimich.com - Gold Coast Health Plan to Invest million in Ventura County's Medi-Cal Provider Network to Connect Members with Care

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Innovative incentive and grant programs are aimed at driving health care equity and access in Ventura County

CAMARILLO, Calif. - Michimich -- Gold Coast Health Plan (GCHP) is transforming the health care system in Ventura County with a groundbreaking $75 million investment in its provider network. Through the development of innovative incentive and grant programs, GCHP is on a mission to connect members with high quality primary, specialty, and behavioral care and empower providers with the vital resources they need for service expansion and to create efficiencies. This strategic investment includes a drive to recruit providers, expanding access to quality health care services. With the scale and ambition of these initiatives, GCHP is setting a new standard for quality care and blazing a trail in community investments.

"Gold Coast Health Plan is committed to supporting providers in innovative ways to achieve our mission of the best health and health care possible for our members," said Nick Liguori, GCHP's chief executive officer (CEO). "These programs reinforce GCHP's ongoing commitment to driving meaningful quality improvements in Ventura County's health care system and providing the necessary financial support for a much-needed infusion of equipment and technology that will provide needed care, along with additional providers to support our community."

Of the $75 million, $50 million is allocated for provider incentives to increase the number of members who complete important annual screenings and condition-specific testing. An additional $25 million is available for grants for medical equipment and to expand and strengthen the medical provider network in the county. This investment in the health care system is aimed at realizing the quality vision of the state Department of Health Care Services (DHCS).

"These initiatives are poised to get more Medi-Cal members connected with care," said Dee Pupa, chair of the Ventura County Medi-Cal Managed Care Commission, which governs GCHP. "Each incentive that is earned and grant that is awarded helps bridge the gaps in health care equity and access, and ultimately drives improvements in health care for our community. The GCHP leadership team has our full support as they embark on the largest community investment in the health plan's 12-year history."

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Quality Incentive Program
Through new contracting arrangements, GCHP's largest provider systems – which serve 90% of GCHP's members – have the opportunity to earn up to $10 million over two years to integrate the operations and data sharing necessary to drive improvements in health care quality performance measures that DHCS selects for Medi-Cal managed care plan annual reporting.

Provider systems must work to improve scores in 10 quality measures over two years. They can choose any five performance measures for which plans are held to a minimum performance level; five are assigned by GCHP:

Child and Adolescent Well-Care Visits
Well-Child Visits in the First 30 Months of Life (0-15 months)
Well-Child Visits in the First 30 Months of Life (15-30 months)
Chlamydia Screenings in Women
Cervical Cancer Screenings

"Gold Coast Health Plan and its providers must work together to get members into care," said Erik Cho, GCHP's chief policy and program officer. "In doing so, we will move the needle on these measures, which translates into a healthier population."

GCHP is working to expand this program to its other provider partners to cover the remaining 10% of members.

Grant Programs
As part of GCHP's mission to continue to build and improve equity and access across the Medi-Cal system of services and support in Ventura County, the organization's two groundbreaking grant programs for providers will elevate health care services, access, and outcomes for its members countywide:

Equipment Grant Program: Supports the purchase of equipment that will expand the capacity of Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) to serve Medi-Cal members in Ventura County and impact direct patient care. FQHCs and RHCs serve medically underserved and rural areas and provide services on a sliding scale based on the individual's ability to pay. In Ventura County, FQHCs include Clinicas del Camino Real and the county Health Care Agency; Community Memorial Health System has RHCs.

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Eligible equipment includes, but is not limited to, lifts, platform scales, hi-low exam tables, vaccine refrigerators, and exam room equipment for clinic expansions.

The goals of this program are to:

Increase capacity within specific service areas and improve direct patient care.
Improve practice efficiencies and/or improved member experience.
Improve member health outcomes.

Grant requests may include more than one piece of equipment; however, the total funding request may not exceed $50,000 per application. FQHCs may submit multiple applications.

Recruitment Grant Program: Addresses the critical need for attracting and recruiting health care providers and other advance practice providers to build a sustainable and effective health care delivery system to increase access to quality health care services. The program is designed to:

Attract and recruit prospective specialists, primary care physicians, and advance practice providers to build a sustainable and effective health care delivery system that addresses the needs of GCHP members and expands access to the county's vulnerable populations.

The maximum award is $200,000 for physician providers and $125,000 for Advanced Practice providers. This program is open to all contracted network providers. Applicants must demonstrate a shortage for the type of provider for which they are recruiting, and/or demonstrate a lack of capacity that impacts access to health care services.

The term of the grants is two years, beginning when the first grant payment is made after recruitment expenses are submitted, and ending two years after the date of the first grant payment.

Both grant programs are now open. Applications will be accepted while funding is available.

About Gold Coast Health Plan
Gold Coast Health Plan proudly serves more than 250,000 Medi-Cal members in Ventura County through its network of primary care physicians, specialists, behavioral health providers and hospitals. Since it was founded in 2011, Gold Coast Health Plan has been committed to providing access to high-quality care and improving the health of its members, which include 1 in 3 county residents, 1 in 6 seniors, and 1 in 2 children up to the age of 5. To learn more, visit: www.goldcoasthealthplan.org.