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Safety-Net Hospital Systems Transformation in the Era of Health Care Reform

Publication date: 
Monday, April 6, 2015

With its strategic focus on supporting value-based care in the safety net, Blue Shield of California Foundation offers support and resources to guide and inform safety-net settings as they transition in this new environment.

Safety-Net Systems Transformation in the Era of Health Care Reform: Experiences, Lessons, and Perspectives from 13 Safety-Net Systems Across the Nation identifies how safety-net systems are striving to thrive and compete in what has largely become a “two-canoe situation”— that is, systems continue to operate out of necessity on a per-service basis, while recognizing the importance of transitioning to focus on population health. Through a review of transformations occurring at safety-net systems varying financially in Medicaid expansion states, this report - produced by Dennis Andrulis and colleagues from the Texas Health Institute - offers first-hand experiences, promising practices, and lessons learned to inform safety-net settings, especially public hospitals, in California and across the country. Among the findings:

Systems are moving toward new value-based payment and care delivery models, but will need sufficient state and federal support to make the transition;

Many recognize the importance of investing in “whole person care” and integrating services that address broader social determinants of health;

Collaboration, with both traditional and non-traditional partners, has become necessary to survive and thrive in new competitive environments; and

Strong, yet flexible leadership, reassessment of strategic goals and objectives, and staff transitions are important to facilitating successful transformation.

In some states, like California, a critical backbone to systems transformation is the Section 1115 Medicaid Waiver’s Delivery System Reform Incentive Payment (DSRIP) program. A recently-released concept paper outlines how the DSRIP can continue to support California's safety net hospitals in this exciting time of change. 

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