Health Reimagined Initiative:
Los Angeles County
Health Reimagined is Blue Shield of California’s ambitious plan to transform our healthcare system with innovative ideas and new technologies that improve quality while making care more affordable. We’re collaborating closely with medical providers, employers, community leaders, and others throughout the state to make this vision come to life.
Health Reimagined focuses on three categories:
• High-tech, high-touch support
We’re implementing a suite of technology tools
and services to support care that is safe, effective, and efficient, while removing distractions, inefficiencies, and burdens from the provider and member experience.
• Personal care
Our care model is patient-centered, data-driven,
and evidenced-based. It gives patients and their physicians the tools, time, and space to address complex health issues, and supports and rewards better-quality health outcomes.
• Holistic health
By addressing social, environmental, clinical, genetic, and behavioral drivers of health
and connecting members to essential community services, we’re helping improve the
health of our communities.
We have launched multiple pilot programs in four counties throughout California: Butte, Los Angeles, Monterey, and Sacramento. Each of these regions has unique characteristics and needs that will help us understand which approaches are most effective, and how they can be scaled and made available in other parts of the state.
Health Reimagined in Los Angeles County
In Los Angeles County,we are helping transform healthcare in this large and diverse metropolitan region. Through Blue Shield of California Promise Health Plan and our collaboration with local providers and well-known community-based organizations, we’re addressing the needs of under-represented and under-resourced communities. Members of these communities are often confronted with social and economic issues, cultural and generational differences, and pre-existing health conditions.
Pilot program participants
• Blue Shield of California Promise Health Plan
• City of Hope
• Family Care Specialists Medical Group
• L.A. Care Health Plan
• Antelope Valley Cardiology
• Community health solutions
Blue Shield of California Promise Health Plan is collaborating with L.A. Care Health Plan to establish a network of 14 community resource centers that will be a hub for promoting individual and community health.
Additionally, Blue Shield of California Promise Health Plan has provided $1.1 million in support for 12 community-based organizations that actively help improve access to quality care for under served communities in Los Angeles County.
• Community Health Advocate Program
A new Community Health Advocate Program through Blue Shield of California Promise Health Plan is aimed at promoting preventive measures to help manage member health, identify health risks, and improve access to care. These professionals provide personalized telephonic and face-to-face, high-touch care to members in a variety of settings. Additionally, they are equipped with innovative technology and collaborate with community organizations to address health and social disparities. Among services they provide are:
o Acting as a liaison with local community and health care organizationso Coordinating quality healthcare and community resourceso Reducing social challenges and barriers to achieving positive health outcomeso Increasing access to services and care coordination
A provider-to-provider platform, eConsultations allows primary care providers to electronically consult with board-certified specialists covering 70 specialty areas. Providers receive timely advice from specialists through an e-consultation delivered within 24 to 72 hours of the initial request, which they can use to comprehensively address patient-care issues. This approach is highly effective and convenient for both providers and patients.
• Shared decision-making
We enable patients to actively participate with their doctors in choosing the treatment that is right for them. The shared decision-making experience, hosted by WiserCare, a decision-support platform, incorporates each patient’s personal preferences and social determinants of health to co-create holistic decisions on personalized treatment options with patients, their families, and providers.
In Los Angeles County, the service is available for patients with diabetes and other conditions at Family Care Specialists Medical Group and Blue Shield Promise clinics in Antelope Valley.
• Innovative payment models
We are piloting new, value-based payment models designed to give physicians the flexibility and financial resources they need to deliver essential and specialized medical services to patients. Providers are accountable for patient-centered outcomes they can control and aren’t burdened with additional administrative tasks. We are implementing this initiative in the following practice areas:
o Primary careo Cardiologyo Oncology
Blue Shield of California is an independent licensee of the Blue Shield Association.