Navigating Challenges, Creating Solutions: 2023 Year in Review
A message from Jeff Rideout, CEO
Happy holidays! As I reflect on the year, I extend my sincere gratitude for your continued partnership and collaboration in advancing healthcare in California. It’s been a productive year, and I’m pleased to share some milestones with you:
After an extensive RFP process, we selected Cozeva as the common reporting platform to provide aggregated results reporting for practices participating in the California Advanced Primary Care Initiative, an initiative led by IHA and the California Quality Collaborative (CQC).
IHA committees welcomed several new members and returned to some in-person meetings. Overall, the committees have made recommendations to align AMP measures with the common measures used in new accountability programs of state regulators and purchasers and to redesign AMP’s incentive components for Measurement Year 2024. The committees also recommended standardizing several Symphony inbound and outbound formats and reports. These efforts to find alignment are truly IHA at work.
IHA enjoyed several opportunities to partner with the Office of Health Care Affordability (OHCA) this year. We put forward nominations for the OHCA Advisory Committee, resulting in the selection of five IHA board members to the committee, and welcomed OHCA Director Vishaal Pegany as a guest speaker at our May board meeting and as a panelist at IHA’s Health Policy webinar in June.
IHA also launched our “Did You Know?” campaign using Measurement Year 2021 Atlas information, providing cost and quality insights to IHA-affiliated OHCA Advisory Committee members, and several public presentations to trade associations and policymakers.
We launched IHA’s Stakeholders’ Series, our outreach program designed to bring you regular updates on IHA and industry-wide news and events throughout the year via newsletters, webinars, and other communication channels.
As part of our multi-year Health Equity Roadmap, we began exploring quality measures stratified by race and ethnicity.
Measurement Year 2022 results for our AMP program are now available. Compared to 2021, the 2022 AMP Commercial HMO results saw notable improvements in clinical quality that deliver meaningful impacts on patients:
41,000 more adults were screened for breast cancer
22,000 more adults with hypertension had their blood pressure under control
20,000 more adults with diabetes and hypertension had their blood pressure controlled
Beginning in 2024, four clinical measures will be a significant focus for CalPERS, Covered California, DMHC, and the Department of Health Care Services for performance accountability programs for health plans. The “Core 4” measures are colorectal cancer screening, diabetes blood sugar management, high blood pressure management, and childhood immunizations. These measures are already in the AMP measure set and are included in the California Advanced Primary Care Initiative.
Encounter Data Governance Entity (EDGE)
Our Encounter Data Resource Hub is growing! In 2023, we published over 15 new tools on the hub. Many thanks to our partners, the California Medical Association Physician Services, California Primary Care Association, Health Industry Collaboration Effort (HICE), and Health Net, for their role in developing these valuable, publicly accessible resources!
In addition to the wealth of resources on the resource hub, we also initiated direct, one-on-one technical assistance to support provider practices, provider organizations, and community health centers in improving the quality and throughput of encounter data submission.
As the focus on the “Core 4” increases statewide, submitting accurate and complete encounter data and regular access to clinical/electronic medical record data are essential for demonstrating clinical quality performance. Learn how IHA is supporting Encounter Data Improvement and check out the resources on our hub.
California Advanced Primary Care Initiative
The California Advanced Primary Care Initiative is led by IHA and CQC and includes a coalition of large payers who have committed to work together to align and transform primary care across the state. In 2023, we wrapped up an advanced primary care measurement pilot to assess variation in practice-level performance. IHA also produced an expanded and enhanced cycle of primary care spending results, which included additional populations and payments.
The payment model demonstration project will kick off in July 2024 and run through 2025. The model emphasizes comprehensive, patient-centered care, physical and behavioral health integration, and high-quality outcomes. The initiative drives alignment for investment in primary care, helping physicians achieve financial stability while improving primary care access and patient care.
Symphony Provider Directory
As the statewide platform for provider directory data, the Symphony program has entered an exciting phase, as the program is adding unique providers at the highest rate ever. As we finalized this newsletter, we’ve achieved 53% completion of Symphony’s “Critical Mass Target” with over 324,000 total provider records in production. Symphony is also identifying over 80,000 corrections per month in its data “tuning” process, improving the data quality for Symphony client’s provider information.
Symphony increased its presence at the California state level through advocacy for amendments supporting a provider directory utility for AB 236 and the completion of the Covered California contracting. IHA and Covered California finalized agreements to use IHA's Symphony Provider Directory as the data source for Qualified Health Plans, ensuring that the state insurance marketplace has the most accurate and up-to-date provider directory information. We are currently estimating that Symphony will go-live for Covered California in 2025.
Finally, we welcomed an additional health plan and provider organization as Symphony clients.
Supporting local communities
Over the past couple of years, our commitment to a remote-first workplace has expanded our team across multiple states. Building on our tradition of supporting the Alameda County Food Bank, we’re encouraging our employees to positively impact their communities by donating or volunteering at organizations close to their hearts. I know our team’s spirit of generosity will make a measurable impact over the coming weeks and beyond.
Merry and bright
As we close out 2023, I’m profoundly grateful to all of you for your pivotal role in shaping our success. Together, we’re making significant strides toward transforming healthcare — creating healthier outcomes, more equitable access, and lower costs. We look forward to our continued collaboration in 2024.
From all of us at IHA, we send our warmest wishes for a beautiful holiday season and a Happy New Year!
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