Can California continue to offer cheap health care? Here’s what the new CEO of the state network says [The Sacramento Bee] – InsuranceNewsNet

Jessica Altman took over in March as general manager of Covered California, and even as she settled into a new home in Sacramento she was also touring congressional leaders to convey how much Californians want access to health insurance.

Too often the biggest obstacle to getting it is cost, Altman said in his first interview with The Sacramento Beeand nothing underscored that more than the capped enrollment record in California last year when new federal aid in the US bailout reduced premiums for California enrolled by 20% on average.

Enrollment in plans offered in the California state market jumped to 1.8 million, according to Covered California records, an increase of more than 150,000.

Altman said she must continue to share the story that the financial assistance put in place under the U.S. bailout is having a staggering impact for all Americans who rely on state and federal markets to provide them with a lifeline when they or their family members are unexpectedly struck down by illness and to get the preventive care they need to stay healthy. Federal grants have only been approved for 2022 policies.

“Health care is essential,” she said, “and being healthy is essential to our ability to live happy, healthy lives and pursue the things we want to pursue. It is also, within our society, a great equalizer if used effectively and equitably to support people across our country and in California.

In other words, Altman said, Covered California’s job isn’t done when a consumer pays a premium.

“Our role as a marketplace doesn’t just end when people are covered,” she said. “It goes to what happens next. Does health insurance provide the access people need. Do they have the suppliers they need? Are providers providing high-quality care that actually gives them better health outcomes? So this next phase of accountability (is) not just access to coverage, but access to quality and equitable care.

A native of California, Altman was the state insurance commissioner of Pennsylvania before taking the top job at Covered California. Altman takes the reins of Peter V. Leefounding leader of the marketplace since 2012.

She offered insight into her top priorities during a Q&A with The Bee. We asked what his top three priorities were at the start of his tenure.

Continuously improve the customer experience

The top priority will always be consumer-centric? How can Covered California better serve the customers we have today, better reach the customers we may have tomorrow, and better serve them as they navigate our health care system, which can be too complex.

An example: how can we better support Californians as they transition between types of coverage – whether Medical to private insurers, from COBRA to a covered California insurer, or between plans within covered California or other types of transitions.

What outreach tools and infrastructure do we have to identify these people when they need us and to support them in these processes?

Go further with diversity, equity and inclusion

Fairness is an integral part of our mission. It’s something Covered California has always done. Are providers delivering high-quality care that actually delivers better health outcomes for all enrollees?

This next phase of accountability is not just about access to coverage, but access to quality and equitable care.

There are many things we do from an equity perspective, for example, our outreach to community organizations, our efforts to be included in different communities through California to provide customer service, our desire to be known and understood in all languages ​​and cultures, and our work to ensure that the providers who are part of the network of health plans we contract with are culturally diverse competent and meet the health care needs of our entire population.

“Our work does not stop at the cover”

Our work doesn’t stop at the cover. It comes down to quality.

Over the next few years, we will monitor the performance of our health plans on six key quality measures. We will see our health plans put financial responsibility on the table (pay penalties) if they do not meet the targets of these quality measures.

We talk about things like: How many children they cover receive vaccinations? How many adults undergo life-saving colorectal screenings at the appropriate age? How do they manage to monitor their population’s blood sugar levels and hypertension and improve them? These are the things we know are the drivers of morbidity and mortality.

Incidentally, we will collect and review these metrics not only holistically, but also stratified by demographic factors such as race and ethnicity to ensure we understand any disparities.

Our fairness work and our quality work are both the same and much more than the other. What I mean by that is that quality health care equals equity. Ensuring quality health care will help us achieve equitable outcomes.

What makes you want to do this job?

I come from a family that has worked in health care and is steeped in health care. My dad’s dad was a primary care doctor I remember well, doing house calls even in his 80s with his black leather doctor’s bag and stethoscope. My mother’s father was an obstetrician-gynecologist who provided women’s health services in a very different time.

And both of my parents worked in healthcare and had long careers in healthcare.

The issues hit me close to home both because I saw my family members and loved ones giving their lives and commitment to improving the health care of others and also (because) I seen too many people I love experiencing health issues. I have always been pushed towards the public service, I have never worked elsewhere than in the public service.

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