Task Force Tackles Access, Coverage, Workforce Issues

The state’s health care task force met yesterday with an ambitious end goal and a complex agenda that broached access and coverage issues, as well as health workforce concerns.

The end goal, according to Diana Dooley, HHS Secretary and a co-chair of the task force, is embodied in a single question: “What will it take for California to be the healthiest state in the nation?”

Getting to that simple question is a complex, multi-layered, 10-year effort. Yesterday’s meeting was the third of four opening workshops of the Let’s Get Healthy California Task Force, formed by executive order of Democratic Gov. Jerry Brown.

“We’re spending the first three months on metrics,” Dooley said. “And in the fall we’ll look at processes and systems and make our recommendations.”

One of those measurements concerns health care coverage and access to providers, which also means taking stock of the number and distribution in the state of primary care providers.

“Coverage and access are an important part of health care reform,” co-chair Don Berwick said.

Anthony Wright, executive director of Health Access California, was the guest moderator of yesterday’s meeting. “We think that’s a vital ingredient of reform,” Wright said. “It’s important to get people into the system. The purpose here is to identify the top priorities for improving coverage and access.”

Julie Sonier, a senior research fellow at the State Health Access Data Assistance Center based at the University of Minnesota, outlined the various metrics that are available in California to judge progress in access and coverage, and the places where ongoing data is lacking.

“In our framework project, we did not establish any benchmarks or goal indicators, but there are numerous things we could track,” Sonier said. “Measures had to reflect major goals and provisions, and we focused on outcomes rather than implementation. … They need to be big-picture measures but still meet policy goals.”

California is a step ahead of most states, she said, because it has a number of state-specific surveys, such as the California Health Interview Survey, to mine for data.

“Stakeholders said that the key coverage and access issues are that drill-down on issues is very important,” Sonier said, “and understanding who remains uninsured in California and why. And also there’s a need for better measures of access, for instance knowing the providers who accept Medi-Cal, as well as data so we can consider broadening the definition of provider beyond physicians.”

If the state can properly monitor workforce capability, that would go a long way toward determining whether Californians have access to providers, she said. A big part of getting more people into coverage, Wright said, is to help determine their actual access to care.


“It is important to be able to see how we’re doing on baseline coverage,” Wright said. “It’s a broad goal, and coverage does not necessarily mean access, but it’s a hell of an important piece to do.”

The last of the opening four task force meetings Aug. 21 will focus on the cost and affordability of health care.

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