Merced, CA, January 24, 2019 --(PR.com
)-- Almost half of all residents of Merced County —126,000 people—receive health coverage from the Central California Alliance for Health (the Alliance) and get their health care through its local network of providers, clinics and hospitals. The Alliance is the not-for-profit, Medi-Cal health plan for Merced, Santa Cruz and Monterey counties, and nearly 84,000 of its 350,000 members receive coverage through the Affordable Care Act.
The Alliance’s health care network in Merced County has rated in the top 10 percent nationally for avoiding antibiotic use for acute bronchitis, according to benchmarks by the National Committee for Quality Assurance (NCQA), an independent organization that assesses the majority of health plans in the U.S. Other significant improvements for the Alliance’s network in Merced include: increased ratings for eye exams for diabetes patients, well-child visits that include health education for nutrition and physical activity, improved asthma treatment and access to primary care physicians for 12-19 year olds. Using its HEDIS® (Healthcare Effectiveness Data and Information Set) measures, the NCQA assesses outcomes annually for health plans – covering 70 percent of all Americans enrolled in such plans.
“These ratings show continued progress in addressing key public health issues in Merced County,” said Dr. Dale Bishop, Chief Medical Officer at the Alliance. “When health issues such as asthma and bronchitis are prevalent in the region due to air quality, high ratings on care of bronchitis indicate that a community-based approach is helping.”
“Increasing access to preventive services and health screenings improves patient’s health status and, lowers costs for the whole system,” Bishop continued, noting that the Affordable Care Act enabled a significant portion of Merced County’s population—not previously insured at all—to get coverage and access to excellent healthcare providers through the Alliance.
“Take antibiotic use for bronchitis, for example. Approximately 90 percent of bronchitis infections are caused by viruses, and these are not treatable with antibiotics. Overuse of antibiotics leads to development of resistant organisms that can cause infection and are more difficult to treat, and, of course, cost more money to treat.”
Alliance Honors Its 2018 Health Care Network for High Performance
To acknowledge providers in its network for their partnership and performance on HEDIS measures, the Alliance last year launched its own recognition program, presenting top physicians and clinics in the county with its own Gold, Silver and Bronze Quality Awards—based on the number of Alliance members each clinic serves.
Merced Faculty Associates medical clinic in Delhi is among the clinics recognized by the Alliance for achievements in improving quality of health. The clinic won an Alliance Gold Quality Award—the top award given by the health plan—for work to improve patient care based on HEDIS measures in the category of clinics serving 1,000 plus members. Rebecca Shaw, CEO of the clinic, agreed that collaboration is key.
“We review data provided by the Alliance and our medical records system from the prior year and look for measures we feel are attainable and most beneficial for patient care. This last year we concentrated on asthma, diabetic patients, well-child and well-adolescent visits. We’re excited to see the efforts we’ve put forth are not only recognized by the Alliance but help us achieve better health for our patients.”
While Merced, a mostly rural county, still faces many challenges around access to health care and a dearth of providers, the Alliance has been working with local clinics to do all they can to boost health outcomes. Besides extensive efforts to bring more physicians and nurses to Merced, the Alliance is partnering with two California State Universities to bring additional medical training to the county. The Alliance also supports telehealth options to increase physician access from remote areas, offers a 24-hour nurse advice line for members and encourages clinics to expand office hours to accommodate workers’ schedules.
The Alliance has been “painting the town” in health messaging to amp up health outcomes related to national quality measures, and for the good of the overall community. To boost awareness of childhood immunizations in Merced County, the Alliance spearheaded a campaign to hang banners over Merced streets, post messages on billboards, collaborate with school nurses, send mass postcard mailings and create looping video messages played in hospitals and doctor’s offices.
These efforts are all just pieces of the puzzle in collaborating to improve health quality, Bishop said. “Health care providers identify the problems they are facing and present them to us. We help them figure out how to get patients in the door for treatment—that means going above and beyond the call of duty to make that happen. These results reflect our providers’ dedication to excellence and members’ dedication to their personal health care.”
2018 Winners of Alliance Gold, Silver and Bronze Quality Awards in Merced County:
100-1,000 Medi-Cal Members
· Gold Quality Award: Golden Valley Health Center, Newman
· Silver Quality Award: Newman Medical Clinic, Newman
· Bronze Quality Award: Merced Faculty Associates, El Portal
1000+ Medi-Cal Members
· Gold Quality Award: Merced Faculty Associates, Delhi
· Silver Quality Award: Long Thao, MD, Merced
· Bronze Quality Award: Livingston Community Health, Livingston
About the Alliance: Central California Alliance for Health, the Alliance, established in 1996, serves approximately 350,000 members in Santa Cruz, Monterey and Merced counties. Using the state's County Organized Health System (COHS) model, the Alliance delivers innovative community-based health care services with the goal to improve medical outcomes and cost savings. The award-winning plan employs nearly 600 staff members in the three counties and manages a budget of $1.1 billion. The Alliance prides itself on its close partnership with contracted providers to promote prevention, early detection and effective treatment, and overall to improve access to quality health care for its members.
About the NCQA: NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s website contains information to help consumers, employers and others make more informed health care choices.
About HEDIS: HEDIS is the measurement tool used by the nation’s health plans to evaluate their performance in terms of clinical quality and customer service. HEDIS is a registered trademark of the National Committee for Quality Assurance.