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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 interviewed health care entities and stakeholders across California to identify strategies that 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.

Resources

The following are summaries and other resources that describe successful cost-reducing strategies.

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 delivery 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.

Contact

Contact OHCA at ohca@hcai.ca.gov with any questions, comments, or if you would like to propose a cost-reducing strategy for consideration. Indicate “Cost-reducing Strategies” in the email subject line.

OHCA is seeking cost-reducing strategies from health plans, hospitals, and physician organizations. If you would like to propose a cost-reducing strategy for consideration, please include a brief summary of the following in your email:    

  • Description of the strategy: An overview of the cost-reducing strategy, what it is, and how it functions. Explain what was implemented, who the population of focus is, who the market is, etc.
  • Purpose: Rationale for implementation and the problems it is/was addressing in your organization.
  • Results: Quantitative and/or qualitative indicators of success that demonstrates how the cost-reducing strategy reduced cost and improved or maintained quality of care. Do not include Personally Identifiable Information (PII) or Protected Health Information (PHI).
  • Barriers or challenges: Description of any barriers or challenges your organization faced in implementing the strategy and if or how the cost-reducing strategy has evolved over time to address these.

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.