Promote High Value System Performance

Cost-Reducing Strategies

Overview

The Office of Health Care Affordability (OHCA) is working with health plans, hospitals, and physician organizations to highlight examples of cost-reducing strategies – efforts to reduce cost while improving or maintaining quality – that have demonstrated results. OHCA invites health care entities and stakeholders across California to share strategies that help reduce overall system costs and are sustainable for the entity to implement and maintain. These strategies can be a resource to support health care entities in meeting OHCA’s health care spending growth targets.  

OHCA did not independently verify information about strategies and results provided by health care entities. OHCA does not endorse any specific health care entity or strategy. OHCA has identified these as helpful examples of cost-reducing strategies that can be a resource to health care entities.  

Please see our OHCA Background & Resources page for more information on OHCA.

Strategies

The following are presentations that describe cost-reducing strategies submitted to OHCA and presented to the Health Care Affordability Board.  

Sharp Rees-Stealy Medical Group 

Sharp Rees-Stealy Medical Group (SRSMG), based in San Diego, is a multispecialty group staff model with 538 physicians – 213 primary care physicians and 325 specialists – at 22 locations. In addition to primary and specialty care, services include physical therapy, radiology, laboratory, pharmacy, optical, and urgent care services. SRSMG is part of Sharp HealthCare, a not-for-profit health system. 

Anthem Blue Cross (Elevance) 

Anthem Blue Cross (Elevance) is a national health company that serves more than 117 million people across the United States. Anthem Blue Cross is the Elevance health plan in California. Elevance uses an integrated whole health approach and focuses on four core areas – whole health, exceptional experiences, care provider enablement, and a digital platform.  

MemorialCare 

MemorialCare, established in 1997, is a nonprofit integrated health system in Orange and Los Angeles County that serves about 1.7 million patients each year. The health system includes hospitals, medical groups, a health plan, outpatient health centers, urgent care centers, physical therapy centers, free-standing imaging centers, ambulatory surgical centers, and dialysis centers. MemorialCare offers primary care at over 30 health centers and has 245 sites of care.  

Blue Shield of California 

Blue Shield of California is a nonprofit health plan aiming to provide Californians with high-quality, affordable health care. Blue Shield of California is an independent member of the Blue Shield Association with over 4.8 million members and over 7,500 employees. Blue Shield affiliates offer health, dental, vision, Medicaid, and Medicare healthcare services plans in California.  

Adventist Health 

Adventist Health is a faith-based, nonprofit, integrated health system that serves more than 80 communities in the West Coast and Hawaii. Adventist Health has over 400 sites of care and 26 acute care facilities. They provide care in hospitals, clinics, home care, and hospice agencies in rural and urban communities. 

AltaMed 

AltaMed, established in 1986, is a federally qualified health center (FQHC) that serves over 500,000 patients in Los Angeles County, Orange County, and the San Gabriel Valley. AltaMed has over 67 sites and 2.89 million in-clinic and virtual visits annually. They offer an array of services such as primary care, women’s health, dental care and oral health, pharmacy, radiology, and behavioral health services. 

    Proposal Submission Process

    OHCA is seeking cost-reducing strategies from health plans, hospitals, and physician organizations. Examples of a cost-reducing strategy might include a program that addresses a specific population (e.g., complex patients or high utilizers), implementation of best practices for more efficient resource use (e.g., increased use of telehealth), an effort to increase care coordination (e.g., enhanced data sharing or communication), etc. 

    If you would like to propose a cost-reducing strategy for consideration, please contact OHCA at ohca@hcai.ca.gov. Indicate “Cost-reducing Strategies” in the email subject line and include a brief description of your organization and a summary of the cost-reducing strategy you wish to share in your email. A member of the OHCA team will respond within 1-2 weeks with additional information.  

    Contact

    Contact OHCA at ohca@hcai.ca.gov with any questions or comments.