California Health Care Improvement Projects (CHIPs)
California Health Care Improvement Projects (CHIPs) are designed by CHCF Health Care Leadership Program participants with the goal of addressing meaningful challenges or opportunities in health care.
Browse CHIPs to leverage the work of CHCF alumni and find opportunities to collaborate in order to improve health for Californians.
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CHIP: Building New Pathways to Address GI Procedure Critical Backlogs after COVID-19
Gina RossettiLos Angeles County Department of Health Services (LAC-DHS) is a huge organization comprised of multiple large complex facilities with their own unique culture, leadership, policies, and procedures. It can be extremely difficult to implement a system-wide operational approach within the organization due to this landscape, especially in a time limited capacity. Early in the pandemic, LAC-DHS shut down all outpatient GI procedures for six months. This created a huge GI procedure backlog and delay in diagnostic care. Due to COVID-19 budget restrictions, there were no new available resources to solve the problem. Therefore, we needed a multi-pronged innovative strategy to address the backlog and deliver much needed diagnostic and therapeutic services to our patients. Before starting this project, the GI services at LAC-DHS had no standardized electronic data tracking system, no GI specific nursing protocols, and no standard procedure delivery workflows across the system. Our goal was to decrease the GI procedure backlog from 6,000 procedures to 1,500 procedures from August 2020 to March 2021. We accomplished this goal by developing and implementing an electronic procedure queue with triage capabilities, multiple nursing/pharmacy standardized protocols, cross-facility scheduling throughput, and standard policies and procedures across LAC-DHS GI departments.
June 1, 2022View/Download PDF
Advocacy for Pharmacoequity in Medi-Cal Rx
Navneet SachdevaGovernor Gavin Newson issued an Executive order (N-01-19) in 2019 to transition the pharmacy services from Managed Care Plans (MCPs) and Fee for Service to Medi-Cal Rx. It is to be administered by Magellan Medicaid Administration under Department of Health Care Services (DHCS) guidance. MCPs like Central California Alliance for Health (CCAH) provided our historical claims and prior authorization data to facilitate continuation of care for Medi-Cal members. After several delays in Medi-Cal Rx implementation, the pharmacy benefit was finally transitioned from CCAH and other managed care plans to Medi-Cal Rx on January 1, 2022. There were several issues surfaced at go-live. For our plan, we encountered: • 86 Separate operational issues impacting several thousand members. • 7 drug class specific policy issues impacting several thousand members. • 6 operational policy issues regarding appeals/grievances/complaints process, missing peer-topeer review option, others. • Comparing DHCS policies with CCAH’s practices, it was clearly visible that the members don’t have the same rights and have access to similar medications as they would under a MCP. DHCS didn’t hold themselves to the same standards as they would a MCP to. For example, despite having 180 transitional policy in place by DHCS, the claims were still rejecting at point of sale because of DHCS having manufacturer specific rebate contracts in place. Member has been on the medication, but can’t get it because it is not from a manufacturer that have rebate associate. This practice is quite bothersome to me. It would never be tolerated for a commercial plan or a MCP. Medi-Cal members should have the same rights regardless who is responsible for managing their pharmacy benefit. That is the right thing to do!
June 1, 2022View/Download PDF
Overcoming Financial Barriers to Medication Access with Drug Manufacturer Copay Coupon Programs
Karen ChinRemove barriers to medication access, improve a patient’s therapeutic outcomes by preventing under treatment, and increase overall patient care affordability by implementing KP approved drug manufacturer copay coupons electronic claims processing at KP National Specialty Pharmacy (KPNSP).
May 31, 2022View/Download PDF
Leadership and Advocacy for Black Maternal Health Outcomes
Aline ArmstrongBlack birthing mothers and their babies are dying in one of the most progressive and wealthiest cities of the country. I engaged San Francisco’s city officials and the Department of Public Health leadership to do something about health inequities and improve disparities impacting Black/African American birthing people. I had the opportunity to present data on preterm birth, infant mortality and poor maternal health outcomes, address social determinates of health, and advocate for new funds with recommendations to close the gaps. This was important to me because I was a new Director during historical events with a pandemic, Black Lives Matter protests, and racism happening across the country. The goal of the project was how to advocate and receive funds to improve health outcomes for vulnerable population.
May 31, 2022View/Download PDF
Birth-Centered Outcomes Research Engagement (B-CORE) in Medi-Cal
Priya BatraObjective: The project will use deliberative democracy methods to engage stakeholders most impacted by pregnancy-related death in Medi-Cal to generate solutions and design interventions to support equity in maternal health outcomes for Medi-Cal-covered births.
May 31, 2022View/Download PDF
Managing Mental Health Crises on the Telephone (an interim report from my leadership journey)
Anh Thu BuiThe CHIP was a focal point of the CHCF program, but my true CHIP came through learning about myself as a leader during challenging times. Fueled by burning questions and supported by mentors, friends and family, I managed to thrive during the past two years. Given all the crises in the world, and given my personal and professional investment in mental health, what could I do to contribute? How might we improve our communities’ health and wellbeing? (In the face of problems that pre-dated but exacerbated by the pandemic, from health disparities, to social inequities and structural racism.)
May 31, 2022View/Download PDF
Amplifying Health Care Workforce Diversity through Community Empowerment: Capacity Building for Alliance in Mentorship/MiMentor
Consuelo (Connie) CasillasMy project aims to address the six-fold disparity in the California Latinx physician workforce to the populations they serve. This workforce mismatch contributes to health care disparities by diminishing access to care for marginalized populations as well as the delivery of culturally and linguistically sensitive care. This issue hits at the heart of why I pursued medicine over 20 years ago; a desire to provide service to our most vulnerable populations.
May 31, 2022View/Download PDF