1. Health Care Consortium
ACA Readiness Project
Presented to the
Merced County
Health Care Consortium
October 23, 2014
Kathleen Grassi, R.D., M.P.H.
Merced County
Department of Public Health

2. In neighborhoods, in schools and
ACA Readiness Project
2013 Public Health Department funded by:
The California Endowment,
Building Healthy Communities, Merced
Blue Shield of California Foundation
In neighborhoods, in schools and
with prevention.

3. Affordable Care Act Federal legislation signed into law in 2010
ACA Triple Aim Goals:
Improve health care delivery;
Improve the health of populations; and
Reduce health care costs.

4. Why is the ACA Important?
Too many people lack health coverage & care
System focuses on treatment instead of prevention
Inefficient delivery and payment system
U.S. healthcare spending is unsustainable
Low-ranking U.S. health outcomes

5. ACA Components

6. ACA Readiness Project Project Goals:
Increase health care access through coordination of enrollment opportunities
Assess local health care provider capacity
Plan for service integration within and across health care institutions

7. Why Health Care Coverage?
Merced County Estimated Uninsured and Projected Coverage Eligibility (prior to January 2014)
Source: Pacific Health Consulting Group. Early Returns: First Year Covered California and Expanded Medi-Cal Enrollment Trends in Merced County, September 2014.

8. Medi-Cal Enrollment Results
New Medi-Cal Enrollment in Merced County January 1 – June 30, 2014

9. Covered California Enrollment
Covered California Enrollment Characteristics
Source: Covered California
Merced County
(N=8,403)
California
Subsidy Eligibility
Eligible for Subsidies
94%
88%
Age
Less than 18 4% 6%
18 to 25
13%
12%
26 to 34
16%
17%
35 to 44
18%
45 to 54
26%
24%
55 to 64
Ethnicity
Latino/Hispanic
41%
28%
October 2013 to April 2014

10. Health Care Services Sufficient primary care capacity currently
Insufficient specialty care capacity historically
Integration of care, especially PC/BH
Development of prevention services

11. Project Deliverables Expanded Health Care Consortium
Regular Informational Meetings
Coordinated Outreach and Enrollment Efforts
Development of Policy Briefs
Harness the Momentum: From Care to Coverage Summit

12. Innovations Chronic Disease Self-Management
“Now that I have coverage….”
Integration across systems
Health Information Exchange

13. Contribution to Premature Death
2002
Social circumstances 21%
Environmental exposures 7%
Behavioral patterns 57%
Medical care 14%
2007
Adapted from: McGinnis JM, Williams‐Russo P, Knickman JR.
“ The case for more active policy attention to health promotion”. Health Affairs

14. Health Impact Pyramid
Source: Frieden, T. A Framework for Public Heath Action: The Health Impact Pyramid. Am J Public Health. 2010; April; 100(4): 590–595.

15. Partnerships to Improve Community Health
Public Health Strategies
Reduce Exposure to Tobacco and Second-hand Smoke
Increase Healthy Food Options
Create
Physical Activity Opportunity
Expand Access to Chronic Disease Prevention resources
Evaluation
Measure the Impact of Public Health Strategies
Communication
Educate and Inform
The Public, Partners and Policy–makers
Partnerships
Work together with residents, community and faith-based organizations, schools, agencies, and local government
to create health promoting environments where we
live, work, and play

16. ACA Readiness Project
Thank you