Supporting California Primary Care Association in Payment Reform

Dates: 2013-2014

State: California

Client(s): Blue Shield of California Foundation

Services: Training & Technical Assistance, Applied Research & Evaluation, Health Systems Transformation, Policy Development & Implementation

Technical Expertise: Health Care Reform, Integrated Care Models, Safety Net, State and Local Public Health

Blue Shield of California Foundation funded JSI to provide technical and subject matter expertise to the California Primary Care Association (CPCA) in advancing payment reform in the state.

Since April 2011, JSI has supported CPCA in its work to identify innovations in payment reform that will provide California’s health centers with the incentives and flexibility to achieve better health, better care, and improved cost effectiveness.

JSI provided consulting and project management support to CPCA and California’s community health centers in state-level stakeholder and policy conversations regarding payment reform and its relationship to delivery system transformation. JSI also provided facilitation of two payment reform pilot workgroups as they moved from planning to implementation stage. The workgroups were dedicated to advancing: 1) a pilot for a PPS-equivalent per-member-per-month Alternative Payment Methodology (APM) for health centers and 2) a patient-centered health home supplemental payment for high-risk complex Medicaid beneficiaries. Specific activities included: working with CPCA and CAPH stakeholders to propose a rationale and approach to an APM for FQHCs, facilitating discussions with health center leaders regarding how an APM could work in California, and engaging with state and payer stakeholders to refine payment reform policy proposals.


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