DHCS Txoj Kev Ua Kom Txom Nyem Kev Noj Qab Haus Huv
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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.
Kev Noj Qab Haus Huv
- 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 services. 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.
Kev kho hniav
- 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 tau tsim Kev Tshawb Fawb Txog Kev Noj Qab Haus Huv thiab Kab lis kev cai thiab kev hais lus (C&L) Kev Ntsuam Xyuas Cov Pej Xeem Xav Tau (PNA) txhawm rau txhim kho cov txiaj ntsig kev noj qab haus huv rau cov tswv cuab los ntawm kev txheeb xyuas cov kev xav tau kev noj qab haus huv thiab qhov tsis sib xws, tshuaj xyuas kev noj qab haus huv, thiab siv cov dej num txhim kho kom zoo. PNA siv cov ntaub ntawv los ntawm Consumer Assessment of Healthcare Providers and Systems (CAHPS) cov kev tshawb fawb los txheeb xyuas cov kev txhawj xeeb txog kev pab cuam, tsim ib qho kev npaj ua, thiab siv cov tswv yim tsom rau kev kawm txog kev noj qab haus huv.
- 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 txuas ntxiv siv cov kev tshawb pom los ntawm Dental Transformation Initiative (DTI) Domains 1-4 thiab Proposition 56 kev qhia txog kev siv. Ua raws li kev txhim kho txuas ntxiv siv cov ntaub ntawv thoob plaws xeev thiab thoob plaws lub nroog, DHCS lub hom phiaj txhawm rau txhim kho cov txiaj ntsig kev kho hniav rau kev mus ntsib Kev Kho Hniav Txhua Xyoo, kev pabcuam tiv thaiv, thiab siv cov sealants, thaum lub tswv yim txoj hauv kev los txo cov kev mus ntsib Emergency Department.
Tswj Kev Kho Mob
- Qhov kev zov me nyuam tswj hwm ua cov ntawv tshaj tawm txog kev noj qab haus huv tsis sib xws txhua xyoo thiab qhia cov ntaub ntawv nrog cov phiaj xwm saib xyuas kev tswj hwm (MCPs) yog li cov phiaj xwm tuaj yeem tsim kho cov peev txheej txhim kho kom zoo rau cov phiaj xwm pej xeem.
- 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 yuav tsum tau ua qhov Kev Kawm Txuj Ci Kev Noj Qab Haus Huv thiab Kab lis kev cai thiab kev hais lus (C&L) Kev Ntsuam Xyuas Cov Pej Xeem Xav Tau (PNA) uas txheeb xyuas cov tswv cuab kev noj qab haus huv thiab kev coj cwj pwm, kev kawm txog kev noj qab haus huv ntawm cov tswv cuab thiab C&L cov kev xav tau, kev noj qab haus huv tsis sib xws, thiab qhov tsis sib xws hauv cov kev pabcuam cuam tshuam txog cov teeb meem no. Lub hom phiaj ntawm PNA yog txhawm rau txhim kho cov txiaj ntsig kev noj qab haus huv rau cov tswv cuab thiab xyuas kom meej tias MCPs tau ntsib cov kev xav tau ntawm tag nrho lawv cov tswv cuab Medi-Cal.
- 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 tuav ib lub hlis twg kev noj qab haus huv tsis sib xws hauv webinar series uas suav nrog kev nthuav qhia los ntawm cov koom haum thiab cov tsev kawm ntawv thoob plaws hauv lub xeev tsom rau ntau yam kev noj qab haus huv uas cuam tshuam tsis zoo rau haiv neeg / haiv neeg ntawm peb cov pej xeem Medi-Cal. Txhawm rau koom nrog cov npe xa email kom tau txais email ceeb toom rau cov webinars no, sau npe rau email hloov tshiab.
- Ua haujlwm nrog cov chaw saib xyuas kev noj qab haus huv hauv nroog, cov neeg muaj feem cuam tshuam thiab cov koom haum koom tes, suav nrog CDPH Lub Chaw Haujlwm Saib Xyuas Kev Noj Qab Haus Huv Equity thiab California Reducing Disparities Project (CRDP), txhawm rau txhim kho thiab siv cov kev cuam tshuam zoo los tshem tawm qhov teeb meem kev noj qab haus huv thiab txhim kho kev paub paub txog kev noj qab haus huv kom tau raws li cov neeg xav tau ntawm Medi-Cal.
- Los ntawm Public Hospital Redesign and Incentives in Medi-Cal (PRIME), cov kev saib xyuas kev noj qab haus huv rau pej xeem tau khaws cov ntaub ntawv ntawm cov pej xeem, tshuaj xyuas lawv cov ntaub ntawv los txheeb xyuas qhov tsis sib xws, tsim ib txoj kev npaj los daws qhov teeb meem tshwj xeeb uas tau txheeb xyuas qhov tsis sib xws, thiab ua tiav txoj kev npaj txo qhov tsis sib xws. Thaum xaus ntawm PRIME, tsim thiab sim cov kev cuam tshuam rau kev txo qis qhov sib txawv yuav txuas ntxiv mus hauv Qhov Kev Pabcuam Zoo (QIP).
- Qhov Kev Pab Cuam Zoo (QIP). Raws li ib feem ntawm qhov kev them nyiaj-rau-kev ua tau zoo rau cov tsev kho mob pej xeem, pib xyoo 2021 DHCS yuav suav nrog ob qhov Kev Txhim Kho Kev Ncaj Ncees. Cov kev ntsuas no yuav txhawb nqa cov tsev kho mob thiab cov chaw kho mob pab Medi-Cal cov neeg mob kom kaw qhov sib txawv ntawm kev noj qab haus huv tsis sib xws uas tau txheeb xyuas hauv xeev lossis hauv cheeb tsam.
Thov rov qab mus rau cov ntaub ntawv qhia txog kev cuam tshuam ntxiv!