Laying the Foundation for Health Care Reform: Local Initiatives to Integrate the Health Care Safety Net

Source: Annette Gardner, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, and the Center for Labor Research and Education, University of California, Berkeley, April 30, 2012

From the abstract:
The Patient Protection and Affordable Care Act (ACA) provides an opportunity to coordinate care among health care providers and transform local safety nets into seamless systems of care. Dr. Gardner’s study of safety net integration activities in five California counties–Contra Costa, Humboldt, San Diego, San Joaquin, and San Mateo–confirmed that these counties had already made a great deal of progress. Each county is focusing on systems-wide integration, cross-provider integration, and patient-level integration. In addition, there is evidence that many of these integration initiatives have increased coordination of care and strengthened partnerships between providers and county agencies, thereby facilitating implementation of health care reform. Though there are differences in capacity and in the resources counties bring to bear, the study nonetheless identified specific strategies and models that can be adopted by other counties, particularly in the areas of specialty care access, mental health and primary care integration, patient care coordination, and outreach and enrollment. This report describes the factors that affect the ability of a local safety net system to develop integrated delivery systems. It also discusses lessons learned from the implementation of 30 safety net integration “best practices” that can be applied to other counties.

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