Two innovative programs to support the region’s health care needs – especially access to primary care physicians – are currently at work on the Central Coast. Both are administered by CenCal Health, the local Medi-Cal health plan serving one in three residents of Santa Barbara County and one in four residents of San Luis Obispo County.
The Medi-Cal Capacity, Access and Workforce Development Grant Program was recently developed to expand healthcare capacity through strategic funding aimed at provider recruitment, and workforce training and education.
Started in January, CenCal Health will soon award its first round of grants up to $3 million, with a planned total distribution of $6 million over three years.
In addition, $4.2 million was recently distributed in a quarterly payment to local primary care providers participating in the Quality Care Incentive Program (QCIP).
QCIP directly rewards Medi-Cal providers who deliver exceptional medical care in their community, emphasizing the clinical priorities of significance to Medi-Cal members, such as diabetes and asthma care, breast cancer and cervical cancer screenings, and child and adolescent well-care visits.
Since the QCIP program began in March 2022, many individual aspects of care have seen significant improvement, such as antidepressant medication management from a baseline of 57.3% to 72.7% compliance with treatment guidelines.
Well-child visit utilization for infants to 15 months of age improved from 50.6% to 65.8%. Lead testing in children improved from 59.1% to 72.5% compliance with established guidelines for abnormal blood lead testing.
“To have communities that truly thrive, quality health care needs to be available to those in need,” said CenCal Health CEO Marina Owen.
“Launching these groundbreaking initiatives – under the direction of our Board of Directors and with the support of our local provider partners – marks a significant milestone in our shared commitment to improve access and equity in healthcare on the Central Coast,” Owen said.
CenCal Health partners with some 5,000 physicians, hospitals, and other providers in delivering health care services to more than 240,000 members.
Aligned with the needs identified in the latest Community Assessment Reports for San Luis Obispo County and Santa Barbara County, the Medi-Cal Capacity, Access and Workforce Development Program is focused on behavioral health, pediatrics and primary care, and specialty care services.
Potential grant applicants include healthcare organizations, such as primary care clinics and behavioral health practices who are contracted Medi-Cal providers or those who are interested in joining the CenCal Health provider network; community agencies serving the Medi-Cal population; organizations developing education pathways or supporting technical and healthcare training, and entities focused on bolstering the healthcare workforce.
Implemented through an application based-grant process, the $6 million program makes available competitive 12-month grants through three rounds of funding.
Program applications and additional information on the grant program are available at cencalhealth.org/providers/medi-cal-capacity. First round grant applications are due by 5 p.m. Feb. 1.
To focus on key needs, CenCal Health referenced internal data, including two annually conducted reports and a biannual member survey managed by the California Department of Health Care Services, as well as each county’s recent Community Assessment Reports.
“Specifically, we are focused on pediatrician recruitment, retention, and other support for pediatric practices to increase Child and Adolescent Well Care Visits,” said Dr. René Bravo of Bravo Pediatrics in San Luis Obispo and a member of the CenCal Health Board of Directors.
“Similarly, we need to open up opportunities for Adolescent and Adult Depression Screenings and increase the number of behavioral health providers to enhance treatment options for patients,” said Dr. Bravo, who also serves as president-elect of the California Medical Association.
In addition to rewarding Medi-Cal providers who deliver exceptional medical care in their community, QCIP payments are also tied to the diversity of members cared for by each provider and payments increase to reflect the proportion of patients of greater clinical complexity, for example, the aged or those disabled.
The most recent QCIP distribution of $4.2 million went to 87 primary care providers (PCPs) on the Central Coast; recipients can be single physician providers or physician groups. Top providers for the third quarter of 2024 (July-September) include Jeffrey Kaplan, MD Inc. Pediatric Medicine in Santa Maria; Community Health Centers of the Central Coast; Central Coast Pediatrics in San Luis Obispo; Sansum Clinic; Jackson Medical Group, and Lompoc pediatrician Dr. Cindy Blifeld.
“QCIP maximizes medical services by delivering both additional information and funding on behalf of more vulnerable patients,” said Dr. Richard J. Macias, CEO/president of Central Coast Pediatrics Inc, a QCIP participant in San Luis Obispo.
“The program helps providers like us to more fully support the pediatric patient, who often require more time, including preventative care,” Dr. Macias said. “We appreciate what QCIP can accomplish for CenCal Health members and their families.”
Since the program’s inception in March 2022, $39.6 million have been distributed to PCPs in San Luis Obispo and Santa Barbara counties. The QCIP distribution for fourth quarter 2024 (October-Decemeber) will take place later this month.
“Both QCIP and the new Workforce Development Program help CenCal Health and the local provider community improve health outcomes.” said Owen. “We are united in our efforts to broaden access to care for everyone on the Central Coast.”
More about CenCal Health is available at cencalhealth.org. Review CenCal Health’s 2024 Community Report at www.cencal2024.org.