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San Francisco Health Network outlines plan to implement Medi-Cal waivers, warns data work is central
Summary
San Francisco Health Network staff told the Health Commission they have named project leads and are building data teams to implement statewide Medi-Cal waiver programs (PRIME and the Global Payment Program), but stressed that defining 57 metrics and capturing "nontraditional" visits in electronic records are major challenges.
San Francisco Health Network leaders told the Health Commission that implementing the state—s new Medi-Cal waiver programs will require intensive data work and system changes to capture previously uncounted services.
Hallie Hanna, director of primary care, said the network is preparing to implement PRIME (Public Hospital Redesign and Incentives in Medi-Cal) and the Global Payment Program (GPP). The programs aim to align payment with population-health outcomes rather than volume of visits, Hanna said, and will require the network to report on dozens of new metrics and to claim points for nontraditional services the network previously did not bill for.
Hanna said PRIME includes seven required projects and that the network selected three…
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