Publication Date

Spring 2024

Degree Type

Master's Project

Degree Name

Master of Public Administration (MPA)

Department

Urban and Regional Planning

First Advisor

James Brent

Keywords

Health equity, Health plans, CalAIM

Abstract

At the heart of a larger societal movement, the imperative to foster diversity, equity, and inclusion (DEI) is a resounding call to action across all sectors. This pressing concern underscores the need for proactive and equity-centric solutions, including within the American healthcare system. The U.S. Department of Health and Human Services has been instrumental in shaping policies and initiatives, such as Healthy People, aimed at promoting health equity and reducing health disparities. Similarly, the Centers for Medicare and Medicaid Services (CMS) has instituted supplementary compliance requirements to hold healthcare stakeholders accountable for implementing equitable programs designed to eliminate health disparities across the board. In addition to federal and state regulators, other accrediting agencies, like the National Committee for Quality Assurance (NCQA), Accreditation Association for Ambulatory Health Care (AAAHC), and The Joint Commission (TJC), hold healthcare organizations and programs accountable for their actions, requiring them to meet the rigorous standards set by the accreditors.

This research focuses on assessing the current health equity-focused quality improvement initiatives implemented by selected not-for-profit health plans in California, which offer healthcare services to low-income populations enrolled in Medi-Cal, California’s Medicaid program. Their progress is measured against the requirements as outlined by the California Advancing and Innovating Medi-Cal (CalAIM) framework, as set forth by the California Department of Health Care Services (DHCS). CalAIM has established specific milestones each year, and this study analyzes the progress made by these health plans. The goal is to determine health plans’ readiness to fulfill all requirements by the conclusion of the five-year reform period in 2027.

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