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Partnership HealthPlan of California

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Partnership HealthPlan of California
Agency overview
FormedMay 1, 1994; 30 years ago (1994-05-01)[1]
TypeCounty Organized Health System
Headquarters4665 Business Center Drive, Fairfield, CA 94534-1675
38°13′17.172″N 122°8′.992″W / 38.22143667°N 122.13360889°W / 38.22143667; -122.13360889
MottoTogether for your Health
Employees1000
Annual budgetUS$2,800,000,000 (2022) [2]
Agency executives
  • Sonja Bjork, Chief Executive Officer
  • Robert Moore, MD MPH MBA[3], Chief Medical Officer
  • Wendi West, Chief Operating Officer
  • Patti McFarland, Chief Financial Officer
Websitewww.partnershiphp.org

Partnership HealthPlan of California, is an independent, public/private organization serving over 950,000 Medi-Cal beneficiaries in 24 northern California counties: Butte County, Colusa County, Del Norte County, Humboldt County, Glenn County, Lake County, Lassen County, Marin County, Mendocino County, Modoc County, Napa County, Nevada County, Placer County, Plumas County, Shasta County, Sierra County, Siskiyou County, Solano County, Sonoma County, Sutter County, Tehama County, Trinity County, Yolo County, Yuba County. It began operations as a County Organized Health System in 1994,[4] and is currently the largest Medi-Cal Managed Care Plan in Northern California.[5]

Company description

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Partnership HealthPlan of California is authorized by the State of California to provide health care services for Medi-Cal managed care beneficiaries in 24 Northern California counties.[6]

Coverage programs

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  • Medi-Cal. California’s version of Medicaid is the only public program that covers many low-income adults and children.


Other coverage programs have been included in the past:[7]

  • 2002-2005 County Medical Services Program (CMSP) program (Solano and Napa counties).
  • 2007-2014 PartnershipAdvantage, a Special Needs Plan Medicare Advantage program (Yolo, Napa, Solano counties only)
  • 2010-2013 Healthy Families, the California version of the federal Children's Health Insurance Program (Napa, Sonoma, Solano, Yolo counties only). In 2013, the Healthy Families Program was folded into Medi-Cal as part of the Affordable Care Act.
  • 2005-2016 Healthy Kids. Partnership HealthPlan also offered a health insurance product called Healthy Kids to low income children not otherwise eligible for Medi-Cal.[8] In 2016, the Healthy Kids Program was folded into Medi-Cal under California's SB 75, passed in 2015. [9]

History and structure

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In 1993, the State Department of Health Services produced a report entitled “Expanding Medi-Cal Managed Care: Reforming the Health System – Protecting Vulnerable Populations” which served as a blueprint for expansion of Medi-Cal managed care.[10]

The Solano Health Partnership, the predecessor of Partnership HealthPlan, began serving Medi-Cal beneficiaries in Solano County in 1994 as a County Organized Health System. The Solano Coalition for Better Health, a community stakeholder group, founded Partnership HealthPlan.[11] The Coalition began discussing overall health of the Solano County community in 1988 culminating in a contract with the State of California in 1992, beginning operations in 1994.[12]

In 1998, the Solano Health Partnership expanded into Napa County, and changed its name to Partnership HealthPlan of California. Further geographic expansions are listed[13]

  • 2001 Expansion to Yolo County
  • 2009 Expansion to Sonoma County[14]
  • 2011 Expansion to Marin and Mendocino Counties[15]
  • 2013 Expansion to Del Norte, Humboldt, Lake, Lassen, Modoc, Shasta, Siskiyou, and Trinity counties[16]
  • 2024 Expansion to Butte, Colusa, Glenn, Nevada, Placer, Plumas, Sierra, Sutter, Tehama, and Yuba counties[6]

The founding Chief Executive Officer was Jack Horn, who retired in 2015.[17]

Notable programs

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Governance

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Partnership HealthPlan is governed by a board of commissions composed of up to 40 members representing all 24 counties, including physicians, county officials, hospital leaders, providers, PHC health plan members, and public representatives.[38]

See also

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References

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  1. ^ Kevin Green (July 13, 2015). "Partnership HealthPlan of California names new CEO". The Daily Republic. p. A5.
  2. ^ "Partnership HealthPlan of California 2022 Community Report" (PDF). www.partnershiphp.org.
  3. ^ Jennifer Huffman (June 26, 2011). "Moore Says Goodbye to Clinic Ole". Napa Valley Register. p. 1.
  4. ^ "Partnership HealthPlan Grows". Vacaville, CA: The Vacaville Reporter. September 1, 2013.
  5. ^ "DHCS Medi-Cal Managed Care Enrollment" (PDF). California Department of Health Care Services. Retrieved February 20, 2016.
  6. ^ a b "DHCS Managed Care Plan Transition". Retrieved 1 January 2024.
  7. ^ "History of Partnership HealthPlan". PARx Program of Partnership HealthPlan. Retrieved 27 February 2016.
  8. ^ "About PHC". Retrieved 28 December 2014.
  9. ^ Lewit, Eugene (November 1, 2015). "Major Transition with Minor Disruption: Moving Undocumented Children from Healthy Kids to Full-Scope Medi-Cal" (PDF). www.chcf.org. California HealthCare Foundation.
  10. ^ Arleen Leibowitz; Helen DuPlessis (1996). "Restructuring the Medicaid Program". Rand Corporation.
  11. ^ Danny Bernardini. "Partnership HealthPlan Continues Growth Trend". Fairfield: The Daily Republic. pp. A1.
  12. ^ Gage, Larry; Von Oehsen, William (1999). Managed Care Manual: Medicaid and State Health Reform. Clark, Boardman, Callaghan. pp. 8–16.
  13. ^ "PARx Website About us". Retrieved 23 December 2014.
  14. ^ D. Ashley Furness (March 20, 2009). "After three-year delay, Fairfield group set to absorb 47,000 patients". Santa Rosa, CA: Press Democrat.
  15. ^ "Partnership HealthPlan expands to Marin, Mendocino counties". Santa Rosa, CA: North Bay Business Journal. September 12, 2011.
  16. ^ "DHCS selects health plans for rural expansion of Medi-Cal managed care". California Medical Association. Retrieved 21 February 2016.
  17. ^ Kevin Green (July 13, 2015). "Partnership HealthPlan of California names new CEO". The Daily Republic. p. A5.
  18. ^ Howard, Sara (Spring 2024). "Obstetric Unit Closures in Northern California & Impacts on Rural Health". Advancing Health in Northern California. Healthy Rural California: 30–41.
  19. ^ Burns, Ryan (January 29, 2016). "Humboldt's Overdose Death Rate is More Than Twice the National Average; Here's What's Being Done About It". Lost Coast Outpost. Retrieved 21 February 2016.
  20. ^ Espinoza, Martin (April 8, 2015). "Sonoma County sees drop in powerful painkiller prescriptions". Santa Rosa, CA: The Press Democrat. Retrieved 21 February 2016.
  21. ^ "Case Studies: Three California Health Plans Take Action Against Opioid Overuse" (PDF). www.chcf.org. June 2016. Retrieved 16 July 2016.
  22. ^ Laverdiere, Donna; Pereyda, Margarita; Silva, Jason; Tater, Margaret (June 2016). "Changing Course: The Role of Health Plans in the Opioid Epidemic" (PDF). California Heatlhcare Foundation.
  23. ^ Enos, Gary (April 17, 2017). "Rx Summit: Local solutions to crisis require collective effort". Behavioral Healthcare Executive.
  24. ^ CapView Strategies (June 2017). "Responding to the Prescription Opioid Crisis" (PDF). CommunityPlans.net. Association of Community Affiliated Plans.
  25. ^ Lurie, Julia (September 2017). "Inside a Massive, Successful Effort to Stop Prescribing So Many Opioids". Mother Jones.
  26. ^ Smith, Dana (August 1, 2019). "Opioid-Dependent Newborns Get New Treatment: Mom Instead of Morphine". CHCF Blog. California Healthcare Foundation. Retrieved 16 August 2019.
  27. ^ "ResolutionCare Announces Launch of Palliative Care Pilot Program with Partnership HealthPlan of California". ResolutionCare.com. July 13, 2015. Retrieved 21 February 2016.
  28. ^ "Payer-Provider Partnerships to Expand Community-Based Palliative Care". California Healthcare Foundation. Retrieved 21 February 2016.
  29. ^ "Napa Valley Hospice and Adult Day Services Launches Partners in Palliative Care" (PDF). Collabriacare.org. Retrieved 21 February 2016.
  30. ^ Boyd-Barrett, Claudia (19 March 2024). "Palliative Care Movement Achieves Significant Progress in California". California Healthcare Foundation.
  31. ^ Boyd-Barrett, Claudia (19 March 2024). "Palliative Care Movement Achieves Significant Progress in California". CHCF Blog. California Health Care Foundation. Retrieved 26 June 2024.
  32. ^ "Partnership HealthPlan of California Selects Safety Net Connect's eConsult System to Bring Specialty Care to Rural Residents". Reuters. February 17, 2015. Archived from the original on March 1, 2016. Retrieved 21 February 2016.
  33. ^ Packer-Tursman, Judy (July 16, 2015). "Plans, providers say telemedicine improves diabetes management". Managed Care Executive. Retrieved 21 February 2016.
  34. ^ California Department of Healthcare Services (DHCS) (October 2015). "First Annual Innovation Award for Medi-Cal Managed Care Health Plans" (PDF). DHCS.ca.gov. p. 4. Retrieved 21 February 2016.
  35. ^ Moore, Robert (March 13, 2017). "EConsult Implementation Success Depends on Workflow". Health Affairs. 36 (3): 492–499. doi:10.1377/hlthaff.2016.1283. PMID 28264951.
  36. ^ Garcia, Jane; Panush, David (May 15, 2017). "People Leaving Jail Can Easily Get a Medi-Cal Card--Getting Care Can Be Harder". California Health Care Foundation.
  37. ^ Newman, Matthew (March 15, 2022). "Expanding Substance Use Care: Health Plan Teams Up with Seven California Counties". California Health Care Foundation. Retrieved 2 January 2024.
  38. ^ "PHC Board of Commissioners". Retrieved 1 January 2024.
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