Partnership HealthPlan of California
360 Campus Lane, Suite 100
Fairfield, California 94534
Established: May 1,1994
Membership: 144,000 (Medi-Cal); 1,700 (Healthy Kids); 5,000 (Medicare Advantage)
As in many largely rural counties across America, patient access to primary-level health care was one of the biggest Medi-Cal challenges in Solano County, California. Before the Partnership HealthPlan of California was established, Solano Countys three hospital emergency room facilities in the small cities and rural areas between San Francisco and Sacramento were often the primary points of care for local Medi-Cal beneficiaries.
In 1988, active citizens, civic leaders and members of the local medical community formed the Solano Coalition for Better Health to address the problem of countywide health care access for a growing Medi-Cal population. This was the first step toward the establishment of the Solano Partnership HealthPlan on May 1,1994.
Today, the Partnership HealthPlan of California, or "the Partnership," underscores the community-level dynamics achievable through the COHS Medi-Cal managed care model. The strong partnership between the Coalition and the HealthPlan has united Solano Countys medical community and turned its focus on the care access issue and other needs of the local Medi-Cal population. This concerted effort has resulted in the following achievements:
- A reduction in HealthPlan members emergency room usage by more than 60 percent.
- A track record for operating with a consistently low administrative margin (averaging less than five percent a year).
- A reduction of hospital days from 650 to 250 per 1,000 members due in part to the HealthPlans emphasis on preventive care and early intervention.
- Consistently high member satisfaction ratings of 87 to 90 percent. (The HealthPlan conducts focus groups on an annual basis to monitor the ongoing needs and satisfaction levels of its member and provider communities.)
Like its four COHS counterparts, the HealthPlan has created a number of model case management programs including those for its members with asthma and for those who are pregnant. Partnership HealthPlan of California extended its services into neighboring Napa County during 1998, Yolo County during 2001 and Sonoma County during 2009. The HealthPlan continues to explore opportunities for expansion, including geographic expansion to Lake, Mendocino, and Marin counties.
In 2005, the HealthPlan added a second line of business to cover uninsured children who were ineligible for Healthy Families and Medi-Cal. The program, called Healthy Kids, was created out of collaboration with local Children's Health Initiatives in Solano, Napa, Yolo, and Sonoma counties. Enrolled children from 0-18 years of age have access to comprehensive health coverage through the Healthy kids program.
In 2007, the HealthPlan launched its third line of business to assist dually eligible members simplify their health care options through PartnershipAdvantage, the HealthPlan's Medicare Advantage plan. This Special Needs Plan (SNP) combines Medi-Cal and Medicare benefits, including Part D to allow for seamless access to care for dual eligible members. Over 10,000 dually eligible members in Solano, Napa, and Yolo counties are eligible to enroll.
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