The Right Care Initiative’s goal is to apply scientific evidence and outcomes improvement strategies to reduce morbidity and mortality among California’s 15 million managed health plan enrollees. Data from NCQA, The Integrated Health Care Association, the Agency for Health Care Quality and Research, the Commonwealth Foundation, and the Centers for Disease Control indicate three trouble spots where evidence-based patient management and clinical quality improvement will significantly enhance and save lives:
The National Committee for Quality Assurance (NCQA) estimates that improving the cardiovascular disease and diabetes measures among California’s 15 million commercial managed health plan enrollees to the national HEDIS 90th percentile could result in 1,694 to 2,818 Californian lives saved annually. It would also avoid $118 million in yearly hospital costs, 766,401 sick days and $125.56 million in lost productivity. Hospital acquired infections are estimated to kill more than 10,000 Californians per year, and are mostly preventable.
Heart disease, hypertension, diabetes, and prevention of hospital acquired infections are increasingly well understood
scientifically. Like the “100,000 Lives” national campaign for reducing medical errors, this project will improve the
lives of tens of thousands of California enrollees by catalyzing the work of experts and applying evidence based
medicine in the coordinated, managed care model.
Hattie Rees Hanley, MPP, Right Care Initiative Project Director, firstname.lastname@example.org, (916) 323-2704
DMHC publicly launched the Right Care Initiative with NCQA and the Deans of UC Berkeley and UCLA Schools of Public Health in March 2008 at the 1st annual Clinical Quality Improvement Leadership Summit. Since then, ten Right Care summits have been held around the state. Each Right Care gathering is a collaborative effort among medical, pharmacy and quality improvement directors, as well as thought leaders in evidence-based medicine.
State-Wide Right Care Technical Expert Steering Committee Chair, Founding Principal Investigator and University of Best Practices Co-Founder:
Stephen Shortell, PhD, MPH, Professor and Dean, Emeritas, University of California, Berkeley, School of Public Health;
Robert Kaplan, PhD, Associate Director for Behavioral and Social Sciences Research, National Institutes of Health
* View a presentation on the California Right Care Initiative given by Robert Kaplan, PhD: http://videocast.nih.gov/summary.asp?live=10001&debug=0 . Dr. Kaplan formerly led the Right Care Initiative as its Principal Investigator. He is currently the NIH Office of Behavioral and Social Sciences Research (OBSSR) Director.
Jerry Penso, MD, MBA, University of Best Practices Co-Founder and Chief Medical Officer, American Medical Group Association
*The views and content expressed in documents by presenters to the Department of Managed Health Care should not be interpreted as an endorsement by the Department.
Cardiovascular Disease and Diabetes Research Team:
Susan L. Ivey, MD, MHSA, Director of Research, Health Research for Action & Associate Professor, UC Berkeley School of Public Health;
Carol Mangione, MD, MSPH, Professor of Medicine & Public Health, UCLA Schools of Public Health & Medicine
Hector Rodriguez, PhD, MPH, Associate Professor, UC Berkeley School of Public Health
Jan Hirsch, PhD, Assistant Professor of Clinical Pharmacy, UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences
Steve Chen, PharmD, Associate Professor of Clinical Pharmacy, USC
Mary Fermazin, MD, MPA, Chief Medical Officer, Health Services Advisory Group (CMS-QIO)
Thanks to an NIH GO grant (2009-July 2012), the Right Care Initiative received a special opportunity to launch a community-focused effort in San Diego to reach the Right Care Initiative goals of preventing heart attacks, strokes and diabetic complications and piloted the first University of Best Practices. Since then, a Right Care University of Best Practices has been launched in two additional metro areas: Sacramento in 2012 and Los Angeles in 2013. Each UCP is comprised of the major delivery systems of the region, including community clinics, the VA, health plans, and medical groups.
Los Angeles Right Care University of Best Practices Chairs:
Stephen C. Deutsch, MD, Chief Medical Officer, Cedars-Sinai Medical Care
Robin Clarke, MD, UCLA Medical Director for Quality Improvements
(Hosted at USC School of Pharmacy)
Sacramento Right Care University of Best Practices Co-Chairs:
José Arévalo, MD FAAFP, Senior Medical Director, Sutter Independent Physicians Medical Group
Pamela Laesch, MD , Chief Medical Officer, Health Net
(Hosted at Sierra Health Foundation)
San Diego Right Care University of Best Practices and San Diego Demonstration Project Steering Committee Leaders:
Scott Flinn, MD, Univ. of Best Practices Chair and Medical Director, Arch Health Partners
Anthony DeMaria, MD, Univ. of Best Practices Co-Chair; Editor in-Chief, Journal of American College of Cardiology; Founding Director, UCSD Cardiovascular Center
Judith and Jack White, Heart Attack and Stroke Prevention Patient Champions
Jim Dudl, MD, Vice-Chair; Clinical Lead, Care Management Institute, Kaiser
(Hosted at UC San Diego Scripps Forum)
We wish to thank Right Care Initiative supporters: The Sierra Health Foundation, The CA Health Care Foundation, The California Endowment, Judith and Jack White, The CA Office of the Patient Advocate, Novo Nordisk, Genentech, Boehringer-Ingelheim, The Health Services Advisory Group, and Ralphs Grocery Company, which enables research and logistical support by the University of CA, the CA Chronic Care Coalition; as well as our University of Best Practices and our annual leadership summit.