Evaluation of California's Global Payment Program

Résumé du livre

There are approximately 2.8 million remaining uninsured individuals in California and they often have limited access to cost-effective preventive care and mental health services. To address this issue, California initiated the Global Payment Program (GPP), a pilot program included in the state's current Section 1115 demonstration waiver to support public health care system (PHCS) efforts to deliver more cost-effective and higher-value care to the state's uninsured. The GPP seeks to improve care to the uninsured by providing GPP funds that can be used to pay for a broad set of services, including non-traditional services and services provided in non-traditional settings. California developed a system of points to provide a value for each service and to track service use relative to each PHCS's budget. The goal is to provide a flexible payment system that encourages the delivery of high-value services, particularly those in lower-intensity care settings to address the needs of PHCS patients. This report documents findings of the final evaluation of the GPP. Through the GPP, PHCSs have put in place a variety of strategies and offered a wider range of services to improve care for the uninsured in California. Utilization of outpatient, non-emergency services increased over the three-year period, while emergency room services and inpatient days decreased. Non-traditional service utilization increased in different ways across PHCSs, indicating that the PHCSs were able to tailor their services to the needs of their patient populations.