By: David Gorn, CALMatters | July 9, 2018
Diana Dooley may have led the largest agency in California’s government as secretary of health and human services for the past eight years, a job that led to her current post as Gov. Jerry Brown’s chief of staff — but she’s also a country gal from Hanford, in the Central Valley.
So despite the complexity of running an agency with an annual budget of $144 billion, horse sense told her what was basically wrong with the American health care system:
“One of the biggest problems in health care,” Dooley said in an interview last week, “is we pay for treatment of illness but we don’t pay for the advancement of health.”
That idea is at the heart of the state’s effort over the past two decades to revamp its system for delivering health care to the neediest. The strategy has included a shift to managed care, meshing mental health services with physical care and creating programs specifically to coordinate an array of services so patients don’t have to hunt them down one at a time.
More recently, the state has launched several pilot projects designed to make people healthier overall rather than just treat the pain or discomfort of chronic illness. Taxpayers foot the bill for the care of about a third of all Californians through Medi-Cal, the state’s version of the federal Medicaid program for the poor, spending tens of billions of dollars annually on treatment of chronic conditions.
A five-year, $1.5 billion Whole Person Care initiative, begun in 2016, aims to heal heavy users of medical services and save the state money by keeping them out of expensive emergency rooms and hospitals.
And a pilot program was created last year to use food as medicine — to try to reverse chronic illnesses such as congestive heart failure — in projects across seven counties. Officially launched last month, it’s modeled on a project in Philadelphia that showed a roughly one-third reduction in patient costs.
These two state efforts include: