In a policy brief on safety net accountable care organizations in California, UC Berkeley experts recommended nine state policy changes to help ACO development, including the reconsideration of California's corporate practice of medicine doctrine.
"Much of the responsibility for developing the needed [ACO] capabilities must reside with the safety net organizations themselves. But they will be greatly assisted by the development and implementation of a portfolio of legislative policies and payment incentives," the brief reads. Here are the nine recommendations UC Berkeley experts say will reinforce ACO development with safety net providers:
1. The state of California should re-examine its current scope of practice laws and regulations to encourage the broadest possible use of nurse practitioners, physician assistants, pharmacists and other health professionals.
2. ACOs providing care to safety net populations should include public and private safety net provider organizations in its governance structure and ensure physician involvement.
3. The state's Medi-Cal program and other payors should consider bonus payments to safety net providers who concentrate their referrals to high-quality and low-cost specialists.
4. Medi-Cal and other payors should use financial incentives like CMS' Advance Payment Model for rural safety net providers that establish a relationship with private sector partners, including private safety net hospitals.
5. The California Department of Health Services should provide assistance to safety net hospitals to let them take full advantage of financial incentives to adopt electronic medical records and participate in health information exchanges.
6. The state should consider having Medi-Cal and other payors provide a coordination bonus to safety net hospitals that integrate behavioral healthcare into primary care.
7. State and private sector organizations should develop a statewide safety net quality improvement collaborative.
8. Socio-demographic characteristics should be incorporated into ACO reporting, including factors such as race/ethnicity, education, income and place of residence.
9. The state should give serious consideration to modifying California's corporate practice of medicine doctrine to permit new arrangements between hospitals and physicians for clinical integration and cost-effective care.
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"Much of the responsibility for developing the needed [ACO] capabilities must reside with the safety net organizations themselves. But they will be greatly assisted by the development and implementation of a portfolio of legislative policies and payment incentives," the brief reads. Here are the nine recommendations UC Berkeley experts say will reinforce ACO development with safety net providers:
1. The state of California should re-examine its current scope of practice laws and regulations to encourage the broadest possible use of nurse practitioners, physician assistants, pharmacists and other health professionals.
2. ACOs providing care to safety net populations should include public and private safety net provider organizations in its governance structure and ensure physician involvement.
3. The state's Medi-Cal program and other payors should consider bonus payments to safety net providers who concentrate their referrals to high-quality and low-cost specialists.
4. Medi-Cal and other payors should use financial incentives like CMS' Advance Payment Model for rural safety net providers that establish a relationship with private sector partners, including private safety net hospitals.
5. The California Department of Health Services should provide assistance to safety net hospitals to let them take full advantage of financial incentives to adopt electronic medical records and participate in health information exchanges.
6. The state should consider having Medi-Cal and other payors provide a coordination bonus to safety net hospitals that integrate behavioral healthcare into primary care.
7. State and private sector organizations should develop a statewide safety net quality improvement collaborative.
8. Socio-demographic characteristics should be incorporated into ACO reporting, including factors such as race/ethnicity, education, income and place of residence.
9. The state should give serious consideration to modifying California's corporate practice of medicine doctrine to permit new arrangements between hospitals and physicians for clinical integration and cost-effective care.
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