Health Reimagined in Sacramento County
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 participantsDignity 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
Innovations in real-time claims paymentsBlue 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
Community Health Advocate ProgramAimed 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 organizationsCoordinating quality healthcare and community resourcesReducing social challenges and barriers to achieving positive health outcomesIncreasing 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.
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.
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.