In Sacramento County, we are reimagining health with two large, well-established healthcare providers – Dignity Health and Hill Physicians Medical Group. Both have a long history of success working with Blue Shield as Accountable Care Organizations. Now, we are joining forces again to transform care in the local community
Pilot program participants
Dignity Health Hill Physicians Medical Group
Associated Family Physicians
Capital OB/GYN
Dr. Paul Kramer
Summit Orthopedic Specialists
Pediatric Medical Associates of Sacramento
Pulmonary Medicine Associates
Key initiatives
Innovations in real-time claims payments
Blue Shield is working with OODA Health, a San Francisco Bay Area-based technology company, on a real-time claims payments process to make healthcare reimbursements happen more immediately after patients receive care. With this process, patients can have easy-to-read bills that are consolidated and allow them to choose their method of payment, including payment plans. Additionally, providers aren’t saddled with administrative expenses and patient debt/collection issues.
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:
Primary care
Maternity
Pulmonology
Orthopedics
Community Health Advocate Program
Aimed at promoting preventive measures to help manage member health and identify health risks, the Blue Shield-funded Community Health Advocate Program provides personalized, in-home, high-touch community health advocates who are based in Hill Physicians Medical Group practices. Among services they provide are:
Acting as a liaison with local community and health care organizations
Coordinating quality healthcare and community resources
Reducing social challenges and barriers to achieving positive health outcomes
Increasing access to services and care coordination
Two companies collaborating with the Community Health Advocate Program are Unite Us and MySidewalk.
Unite Us is a technology company that builds community networks by helping connect residents with organizations and public agencies that deliver culturally and linguistically appropriate services. With this tool, community health advocates can focus on holistic health on a personal level, and at scale, by identifying an individual’s needs and communicating with outside organizations to create change in the community.
MySidewalk is an innovative platform that provides thousands of data points around social determinants of health and health-related social risk factors such as food insecurity and transportation. The tool, which is available on smartphones and tablets, educates the community health advocates on local areas’ unmet social needs and how these systemic issues have an impact on an individual’s health and well-being.
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. The program has been particularly helpful with maternity patients.
Virtual visits Through a collaboration with Altais Health, we are enabling providers to virtually connect with their patients via their phone, tablet, or computer to receive customized care from their primary care providers. The service has been particularly popular during the COVID-19 pandemic, providing access to needed care while protecting patients and doctors.
Where we’re starting
We’re piloting programs for Health Reimagined in four distinctly different regions throughout the state. Each county has unique qualities to help us understand which approaches are most effective.
