​​​​​​​​​​DHCS's Efforts to Reduce Health Disparities 

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The DHCS Comprehensive Quality Strategy identifies improving health equity as one of four goals to achieve high quality and integrated health care and to integrate into quality improvement work in all DHCS programs.  The following presents a brief summary of the work be undertaken by the Department.

Behavioral Health

• County mental health plans develop and implement cultural competence plans that include objectives for reducing disparities by tailoring best practices in mental health services to beneficiaries' cultural and ethnic background and language preferences. The County Drug Medi-Cal-Other Delivery System (DMC-ODS) plans work to improve access to culturally competent substance use disorder serv​ices. The Medi-Cal Behavioral Health Division established a website that contains information on the Cultural Competence Plan Requirements, Community Mental Health Equity Project, and other resources that will provide helpful information to county behavioral health departments, community-based organizations, state staff, and interested stakeholders. For more information regarding behavioral health projects and resources please refer to  Efforts to Reduce Disparities in Behavioral Health. ​​
  

Dental​

• DHCS is implementing the Quality Improvement and Oral Health Equity Transformation Program (OHETP) with new DMC plans to require rigorous assessment and evaluation of plan performance and practices, including engagement with oral health community advisory committees (OHCAC). OHETP ​also requires engagement with all levels of Medi-Cal Dental stakeholders, including Medi-Cal members, DMC plan board members, local oral health programs, and more. 
• DHCS established the Health Education and Cultural and Linguistic (C&L) Population Needs Assessment (PNA) to improve health outcomes for members by identifying health needs and disparities, evaluating health education, and implementing quality improvement activities. The PNA uses data from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys to identify program concerns, develop an action plan, and implement targeted strategies for health education.
  
• Dental managed care (DMC) plans use demographically stratified data to educate providers and members about the importance of prevention and early treatment of oral diseases and work with dental plans to address and prevent oral health disparities.
  
• DHCS enables providers the flexibility to use teledentistry as a modality to render a broad array of services.
  
• DHCS requires DMC plans to submit a Quality Improvement Annual Report to illustrate their efforts in reducing disparities in reporting areas that need improvement. These reports explicitly state what interventions were taken to detect and address both underutilization and overutilization of services.​
  
• DHCS monitors DMC plans’ network adequacy standards for network capacity and provider to member ratios, timely access, and specialty referrals. DHCS also monitors time or distance standards for members to be within 10 miles or 30 minutes of a network provider.​
  
• DHCS continues to leverage findings from Dental Transformation Initiative (DTI) Domains 1-4 and Proposition 56 utilization reporting. Following continuous improvement methodology using statewide and countywide demographic data, DHCS aims to increase dental benefits utilization for Annual Dental Visits, preventative services, and use of sealants, while strategizing ways to decrease Emergency Department visits.​

Managed Care

• ​The managed care program conducts annual health disparities reports and shares the data with managed care plans (MCPs) so plans can tailor quality improvement resources to target populations.
• MCPs are required to conduct a health equity performance improvement project (PIP) as well as conduct quarterly PIP collaborative calls and presentations that assess three domains (child/adolescent health, women's health, and disease management/behavioral health) and address health equity for each domain.
• MCPs are required to conduct a Health Education and Cultural and Linguistic (C&L) Population Needs Assessment (PNA) which identifies member health status and behaviors, member health education and C&L needs, health disparities, and gaps in services related to these issues. The goal of the PNA is to improve health outcomes for members and ensure that MCPs are meeting the needs of all their Medi-Cal members.
• On an annual basis, DHCS recognizes MCPs) that have excelled in improving the quality of health care for the millions of beneficiaries receiving Medi-Cal services through managed care by giving out Health Equity Awards.​
  

Quality and Population Health Management​ (QPHM)

• QPHM hosts a quarterly health disparities webinar series that includes presentations from organizations and educational institutions throughout the state focused on a variety of health conditions that disproportionally impact the racial/ethnic sup-populations of our Medi-Cal population.  To join the email distribution list to receive email alerts for these webinars, sign up for email updates.
• Works with county health departments, stakeholders and partner organizations, including the CDPH Office of Health Equity and the California Reducing Disparities Project (CRDP), to develop and deploy effective interventions to eliminate addressable health disparities and improve health literacy skills to meet the needs of Medi-Cal members.
• Through the Public Hospital Redesign and Incentives in Medi-Cal (PRIME) program, public health care systems captured granular population data, analyzed their data to identify disparities, developed a plan to address a specific identified disparity, and executed a disparity reduction plan. Upon conclusion of PRIME, designed and tested interventions for disparity reduction efforts will continue in Quality Incentive Program (QIP).
• Quality Incentive Program (QIP). As part of this pay-for-performance program for public hospitals, starting in 2021 DHCS will include two Improving Equity metrics. These metrics will incentivize hospitals and clinics serving Medi-Cal patients to close the gap on health disparities identified at the state or local level.