This report concerns the County entering into partnerships with other
healthcare providers in the County as a means of meeting the surge in
healthcare demand from the Affordable Care Act. Final implementation of the Affordable Care
Act begins January 1, 2014. This
presents both a challenge and an opportunity to develop a comprehensive plan
for an integrated healthcare delivery system in Contra Costa County. With federal healthcare reform, many more
county residents will become eligible for insurance, including Medi-Cal. It is estimated that over 40,000 will remain
uninsured. The increase in demand will
further strain a county system that currently lacks the capacity to adequately
serve the vulnerable population in our county.
Research shows that coordination is vital among healthcare providers in
order to provide access to quality care. Strategic partnerships among public and
private healthcare providers are being formed throughout California and the
nation to plan for the imminent changes.
Their goal is to provide cost-effective, quality care to an expanded
population and re-design systems to improve health outcomes to meet the
increase in demand.
The Board of Supervisors commissioned a sustainability Audit of the
Contra Costa County Health Services Department, and in 2011 the consultants
published their report. One of the
recommendations is for the County to take the lead in developing partnerships
among public and private healthcare providers. The comprehensive Audit completed by a consultant, Health
Management Associates, in September, 2011, and titled “Contra Costa County-Health
Care Sustainability 2011”, begins with the statement:
“It is doubtful that our public health system alone will be able
to meet future medical needs of vulnerable populations in Contra Costa County
without assistance from the private sector.
Public/private partnerships will continue to need exploration and
development when health care reform provides access to care for people who will
be newly or more adequately insured and those who remain without health
insurance.”
Two years have passed since the Audit recommendation was presented to
the County Board suggesting that the County Health Services Department take the
lead in discussions to expand the number and scope of such partnerships. While some effort has been made to explore a
few possibilities, there has been little meaningful change achieved during that
time, and now time is running out. The
County should bring a sense of urgency to its leadership efforts and a willingness
to take steps to seriously engage private sector stakeholders in the challenge
to prepare for the coming change in demand for healthcare services.
This report is not about the Contra Costa County healthcare operation’s
current governance structure, nor is it an analysis of the pros and cons of
possible mergers between the County and private or public sector entities,
although both would be worthy of future Grand Jury investigations.
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