1. The Changing Healthcare Landscape in California Shannon McConville Northern California Grantmakers Annual Conference— From Ideas to Action May 2015

2. ACA Medi-Cal enrollment levels have exceeded expectations 2 SOURCE: Covered California enrollment totals, May 2014; UC Berkeley/UCLA CalSIM model version 1.8.

3. Federal gov’t provides bulk of new Medi-Cal funding, but future state costs uncertain 3 SOURCE: Department of Health Care Services, Medi-Cal Local Assistance Estimates, May 2014 and November 2014

4. Despite coverage gains, 1 million may remain uninsured in Northern and Central regions 4 SOURCE: Lucia et al., 2015, “Which Californians Will Lack Health Insurance Under the Affordable Care Act.”

5. State and county policy strategies to manage costs and improve access and outcomes  State-level – Coordinated care initiative, Health homes for chronic conditions, payment reforms  New Medicaid waivers, state innovation model – Coverage options for undocumented immigrants  SB4, PRUCOL  County-level – Medical homes for uninsured, Electronic Health Records  My Health LA, HealthPAC – Dedicated revenue for county safety net systems  Alameda County Measure A/AA 5

6. But improving the health of Californians requires more than access to medical care 6 SOURCE: Robert Wood Johnson Foundation, Commission to Build a Healthier America

7. The Changing Healthcare Landscape in California Shannon McConville Northern California Grantmakers Annual Conference – From Ideas to Action May 2015

8. Notes on the use of these slides 8 These slides were created to accompany a presentation. They do not include full documentation of sources, data samples, methods, and interpretations. To avoid misinterpretations, please contact: Shannon McConville (mcconville@ppic.org; 415-291-4481) Thank you for your interest in this work.