"This partnership will provide strategic advice and mentoring services to guide our capacity for quality improvement, population health management and organizational change," said Neal Kohatsu, DHCS' medical director. "It will help strengthen our relationships with partner hospitals by emphasizing bi-directional communication, education and interventions that drive improvement in population health."
The five-year, $4.25 million agreement calls for, among other things, the IPHI to design and support a statewide Medi-Cal quality improvement plan, develop a systems-level strategy for DHCS to assess hospitals' success in achieving the goals set forth by the Medicaid Section 1115 waiver's Delivery System Reform Incentive Pool (DSRIP) program, convene a Medi-Cal Performance Advisory Committee of experts in clinical sciences, system thinking, quality improvement and organizational change, and provide quality improvement training and mentoring for DHCS managers.
"The department is focused on improving and enhancing quality care and reducing health care-related costs," said DHCS Director Toby Douglas. "Our agreement with IPHI will help us achieve these interconnected goals."
Medi-Cal is a joint state-federal health insurance program that serves more than 7.6 million low-income and medically high-risk Californians. The DSRIP program is a new component of Medi-Cal that provides federal funds to public hospitals that have demonstrated success in expanding capacity and making services more coordinated, efficient and patient-centered. DSRIP is part of California's five-year, $10 billion "Bridge to Reform" Medicaid Section 1115 waiver, which aims to strengthen the Medi-Cal program and prepare safety net providers for nearly one million newly eligible Medi-Cal beneficiaries in 2014. The 1115 waiver is an agreement between the state of California and the federal Centers for Medicare & Medicaid Services (CMS) that "waives" certain Medicaid requirements in order to test new strategies for improving care and service delivery.
Kenneth W. Kizer, one of the nation's preeminent authorities on public health and health care quality improvement and founding director of IPHI, will lead the effort.
"This partnership will result in better health care for millions of Californians and better value for taxpayers who fund the program," said Kizer, who also is a distinguished professor at the UC Davis School of Medicine and Betty Irene Moore School of Nursing. "We will be developing a clearly defined quality improvement plan for the Medi-Cal program that will include specific quantitative goals and performance measures to track improvement in health care processes and health outcomes, equitable access to care, the prudent use of resources and appropriate matching of resources with needs. In evaluating the DSRIP program and helping develop a systems-level strategy, we expect to make specific recommendations for DHCS and individual hospital systems that will help them achieve DSRIP program milestones and more."
The plan's goals and performance measures will reflect the shared values and best practices of the federal Department of Health and Human Services' National Quality Strategy. DSRIP program evaluations will address interventions in each hospital system plan, including the implementation of electronic health records and use of other health information technology, implementation of patient-centered medical homes, use of evidence-based population health management methods and integration of clinical services to improve the coordination and continuity of care. Kohatsu believes that "Dr. Kizer's extensive knowledge and history of transforming health care in California and across the nation make him an outstanding director of this statewide initiative."
Kizer is a member of the Institute of Medicine of the National Academy of Sciences and a fellow of the National Academy of Public Administration. As director of the former California Department of Health Services for Governor Deukmejian from 1984 to 1991, he pioneered Medi-Cal managed care, led California's response to the HIV/AIDS epidemic, launched California's famed Tobacco Control Program and established a number of leading programs that have become national models of excellence. Some of these include the "5 a Day for Better Health" nutrition program, the California Cancer Registry and California's birth defects monitoring program.
As undersecretary for health in the U.S. Department of Veterans Affairs (VA) for President Clinton from 1994 to 1999, Kizer engineered the internationally acclaimed transformation of the VA health care system, which included the most rapid and largest ever deployment of a system-wide electronic health record and a comprehensive quality improvement and performance management system that has been cited as a model by Harvard University and others. As founding president and chief executive officer of the National Quality Forum (NQF), Kizer led efforts to establish national standards for reporting of health care quality. Today, NQF-endorsed performance measures are widely used by the federal government and throughout American health care.