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Strategic Plan 2022-2026

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Strategic Plan 2022-2026

HEALTH EQUITY

Introduction

Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments and health care (Robert Wood Johnson Foundation).

To fully address health inequities, the health care system will need to shift practices and policies that have traditionally benefitted some groups of people and left others out. The Alliance will seek to understand root causes of health disparities, particularly those experienced by members who identify as Black, Indigenous and people of color (BIPOC).

The Alliance will take an inclusive approach to ensure equity in Alliance policies, processes and results. This will be accomplished by embracing diversity, inclusion and belonging in its workforce, partnering with providers and engaging with members to inform and guide its actions. This approach includes creating opportunities for member inclusion in the Plan’s decision-making processes to improve organizational policies to yield health equity.

Goal 1 - Eliminate health disparities and achieve optimal health outcomes for children and youth.

Almost half of Alliance members are children and youth. Action to ensure the health and wellness of this population is a key step towards health equity for the communities the Alliance serves. The Alliance will partner to identify and act to eliminate barriers to children’s preventive and clinical care and will consider upstream strategies to improve children and youth’s long-term health and wellness.

The Alliance recognizes that not all children and youth experience the same opportunities to reach their full health potential. The Alliance will emphasize early action to close disparities in utilization and/or outcomes for those members most impacted by racial inequity. Simultaneously, the Alliance will work towards an overarching goal of increased delivery of screenings, preventive services and clinical care, so all children and youth achieve optimal health.

Goal 2 - Increase member access to culturally and linguistically appropriate health care.

The Alliance is committed to ensuring that members receive health care services that are high quality, culturally competent and guided by cultural humility. Alliance members speak more than 29 different languages and represent a wide variety of cultures from all over the world. Individuals have better experiences and outcomes when health care is provided with a person-centered approach, when the provider understands and respects the individual’s culture and beliefs and when information is provided in the individual’s preferred and/or primary language.

The Alliance is committed to strengthening the cultural competency of the provider network and the Alliance workforce and will work to expand the provider network to include more providers who reflect the diversity of the Alliance’s membership. The Alliance will operate with cultural humility and will amplify member voices and lived experiences to understand community needs and assets. The Alliance will also partner with members, providers and community-based organizations to better understand and meet member needs.

PERSON-CENTERED DELIVERY SYSTEM TRANSFORMATION

Introduction

Throughout the planning process, the Alliance identified the need to center on the people it serves rather than the health care services it delivers. Such a shift requires a transformation to honor the dignity and self-determination of members and to focus on their health as the intended result, rather than the delivery of health care services alone. This idea represents an evolution towards a system that yields member health through shared decision making and action, rather than a system that simply delivers health care services.

The state’s CalAIM initiative holds promise to reform programs and payments to improve the quality of life and health outcomes for Medi-Cal members. The Alliance’s five-year goals are in alignment with the goals of CalAIM. and will help the Alliance focus on transformative actions to meet member needs, with members’ improved health and well-being as the long-term goal.

Goal 1 - Improve behavioral health services and systems to be person-centered and equitable.

The Alliance will seek to improve the quality and increase member use of behavioral health services through improved coordination, integration and expanded capacity of the behavioral health delivery system. Currently, people with Medi-Cal receive behavioral health services through a complicated, siloed system that requires the member to seek services through different systems depending on severity of mental health or behavioral health diagnosis. The system is not designed to address the member’s expressed need for support or to emphasize prevention, nor does it harness the power of empathy to combat the stigma that prevents healing and recovery. The Alliance seeks to address key impacts of this design, including poorly managed mental health and disparities in utilization across race, age and geographic populations.

The Alliance will engage members and partners to identify and co-create solutions to address barriers to behavioral health services, with an emphasis on providing a culturally sensitive, individualized approach based on a member’s expressed need for support. The Alliance will also work to improve coordination across systems and increase integration of behavioral health services in clinical and non-clinical settings.

Goal 2 - Improve the system of care for members with complex medical and social needs.

Many Medi-Cal members rely on multiple siloed systems to address complex medical and social needs, often without coordination or collaboration across overlapping systems. Social and environmental factors, including a lack of housing, nutritious food and transportation, also have a profound impact on health. There are gaps in delivery system capacity to address those factors because such services are not Medi-Cal benefits or because they fall within shared responsibilities between siloed programs in the delivery system.

To support members with complex medical and social needs to achieve better health outcomes, the Alliance will rely on a population health-based approach and will increase data sharing with providers and community-based organizations to more effectively collaborate and coordinate patient care. The Alliance will also partner with providers and community-based organizations to improve the capacity for community-based care coordination (where members live, work, learn and play). In order to avoid long-term poor health and to improve member health outcomes, the Alliance will partner with community stakeholders to identify and address gaps in services that could support member health. The Alliance will also seek to integrate supportive services that address health-related social needs into the health care.