Welcome Covered California Qualified Health Plans 2021 Plan Updates - April 20, 2021 - California's Health Benefit Exchange
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Welcome
Covered California Qualified Health Plans
2021 Plan Updates
Breakout Room #2
April 20, 2021
WEBINAR HOUSEKEEPING
The agenda, breakout room links and troubleshooting guide can be found at
https://hbex.coveredca.com/toolkit/webinars-briefings/.
• All participants will be in listen-only mode.
Participants • Questions for presenters can be sent to kickoffevents@covered.ca.gov .
Dial in by phone: • Any questions not answered during the webinar will be addressed in an
1-408-638-0968 FAQ which will be sent to all registrants approximately two weeks after the
Meeting ID: event.
867 0606 9878 • Today’s virtual meeting will be recorded and sent via agent and community
partners alerts
• The recording will also be available in two to three business days via
https://hbex.coveredca.com/toolkit/webinars-briefings/.
Refer to the Zoom Troubleshooting Guide found in your Eventbrite email or
Technical
http://www.hbex.coveredca.com/troubleshoot . Email the Outreach & Sales team at
Difficulties kickoffevents@covered.ca.gov.
2
L.A. CARE HEALTH PLAN
Alexander Li, M.D.
Deputy Chief Medical Officer
Melissa M. Gutierrez
Sales & Business Development Director
3
Presenters: Dr. Alex Li Deputy Chief Medical Officer Melissa Gutierrez, Director of Sales and Business Development
L.A. Care is a public option that is meeting the desired goal — a plan that is providing access to
quality health care at an affordable price to a greater number of people. - John Baackes, CEO
L.A. Care Health Plan serves more than 2.36 million
members in Los Angeles County, making it the largest
publicly-operated health plan in the country.
• L.A. Care Health Plan is the public option participating in
Covered California.
• L.A. Care is competitive in the commercial marketplace,
as it is now fourth in the state in Covered California
membership.
• L.A. Care offers some of the most affordable options on
the Covered California exchange.
2019 Marketing Campaigns Strategy | 5
Network-A Focus on Los Angeles
County and Angelenos
Access to one of the largest provider networks among Covered California™ plans and in Los Angeles County. We’re making
health care easier to access. With a network of over 60 hospitals, 3,000 physicians and 1,600 pharmacies there's most likely
an L.A. Care provider close by.
• UCLA, OPTUM, HCLA, • CVS Minute Clinic, Teladoc, • 5 Community Resource
AltaMed, Preferred IPA, etc. Beacon Health Options Centers (CRCs)
60+
Hospitals
3,000+
Physicians
1,600+
Pharmacies
American Rescue Plan and L.A. Care Covered
The American Rescue Plan has positioned LA Care to provide greater affordability to even
more Los Angeles county residents.
• Value of network and ARP Subsidies strengthen L.A. Care, by offering the most affordable Silver Plan in Region 15.
• Communication Plan
• Subsidy notification insert (May Invoice)
• LACCD Off-Exchange Opportunities
• Subsidy alert for May Premiums (Member Portal)
• Member Services, Broker, and Internal Sales FAQ for Member Communications
• Refreshed OEP Media Marketing and Collateral
COVID-19 Goals • To build trust in the safety of the COVID-19 vaccine by dispelling common myths and sharing facts about the vaccine’s safety and availability so that community members decide to — and know how and when to — get vaccinated. • To assist eligible members in accessing the vaccine when it becomes available to them. • To be true to our mission as a public health plan, by supporting public health efforts to end the pandemic. Strategy To position L.A. Care as a reliable source of truth about the COVID-19 vaccine by providing information while being respectful of the histories of the communities that we are serving, so that people can make an informed decision about getting vaccinated. Messaging and tactics will roll out in phases in alignment with the state and county public health departments approved tiers and target populations that are identified by the COVID-19 vaccination program in Los Angeles County.
Addressing Health Equity before and during the
pandemic
• Helping to end the pandemic
• Supporting public health efforts
• Community and political advocacy
• Supporting our community
• Greater than $300 Million in Grants:
• Healthcare coverage (Healthy Kids 0-5
year olds from 2003 to 2016)
• Clinical services/office equipment
• Housing, school supplies and Food
• Supporting our providers
• Greater than $30 Million Dollars to recruit
providers (Elevating Safety Net)
Community Resource Centers (CRC) Vaccination Clinics
• 1,000 doses per clinic x 16 clinics
• 16,000 total doses
• Johnson & Johnson vaccine
• Targeted member outreach by zip code
• Staff calls to high-risk members
• Targeted social media campaign on
standby
• Walk-up, drive-thru, and drop off
options offered
• Members will be able to use their
transportation benefit to get to their
vaccine appointmentMarketing
Here Then, Here Tomorrow Enrollment Team 855.222.4239 • 8am-5pm, Monday – Friday. Member Services 855.230.2327 • 24 hours, 7-days a week Broker Support 855.248.7778 • 8am-5pm, Monday – Friday.
OSCAR HEALTH PLAN
Jesse Hendon
Market Director West Coast IFP Sales
13OSCAR | ARP Covid updates
COVID Vaccines, what we’re hearing and how we’re helping to keep calm and vaccinate
COVID Vaccine
What we’re hearing from members
InboundTrends
● January: Coverage, Eligibility &Availability
● February: Eligibility & Scheduling Logistics
● March: Scheduling; Logistics & Side Effects
RTM Campaign
● Activated for eligible / high risk members
● Top reasons members are unsure or will not get the
vaccine
○ 22% - do not feel it is safe
○ 8% - healthy and do not need it
○ 7% - worried about side effects
○ 7% - do not believe vaccines work
○ 4% - already had Covid
3COVID Vaccine
Outbound campaigns
1) Vaccine-focused educational email
○ Outbound members (English & Spanish)
○ Focus: General COVID resources & FAQs
○ 44% open rate
2) Eligible / high risk member email
○ Using claims data hit high risk members
○ Focus: Eligibility routing & FAQs
○ 48% open rate (benchmark: 41-44%)
3) 2nd dose reminders
○ Hit all members for second appt reminders
○ Focus: side effects, FAQs, virtual UC
○ 58% open rate
4COVID Vaccine
Digital Experience
Website
● 7 vaccine-specific FAQs
● 5 vaccine-focused blog posts / provider
videos featuring Dr. Reznick
● 18 linked State Depts of Health for eligibility*
● 7 linked vaccine scheduling tools / finders
● Traffic on /covid19 pages has increased
217% in first 2 weeks in March
Care Router
● Pharmacy search banner routes vaccine
searches to website tools
● CVS COVID vaccine network tagging
*Most clicked on page 5Culturally Competent Care Grant & Network Expansion
CULTURALLY COMPETENT CARE GRANT
Culture Care
California
Culture Care is a telemedicine startup that links Black
patients to Black doctors by creating specific services
to compensate for gaps in healthcare that
disproportionately affect Black people, such as
maternal and infant mortality.
This grant will help fuel growth of physicians on their
roster who are delivering care and expand their market
to more patients in Southern California, with a focus
on delivering unique telemedicine services to
supplement care for Black women and birthing
people.
7Oscar is proud to announce the addition of Korean American Medical Group to our panel of physicians in LA and OC. KAMG has proudly serviced the Southern CA Korean community for over 30 years and we are excited to be their first health insurance partner that is dedicated to the Covered CA population We believe that KAMG’s established commitment to high quality care and Oscar’s mission to bring high quality care to everyone is the perfect match.
Any more
questions?
Email Jesse Hendon at
jhendon@hioscar.com!
9SHARP HEALTH PLAN
Trent Fields
Account Executive
23Individual & Family Plans Trent Fields I Account Executive – April 20th 2021
Agenda • Sharp Health Plan • Sharp Health Plan Vaccine Support • American Rescue Support • IFP team
Sharp is an integrated Built on a foundation of common systems
delivery system and organizational infrastructure
Sharp Health Plan
· Not-for-profit serving 3.2 million
residents of San Diego County
· Largest health care system in
San Diego with highest market
share
· 3 decades of capitation experience
Sharp Rees-Stealy Sharp Community
Medical Group Medical Group
· Fully licensed health plan serving
the San Diego MSA for 25 years
· 145,000 total covered lives
Hospitals
· Nationally recognized for quality and
service
· Below market-medical cost trend
and administrative costs
Quality & Physician Customer Population IT Leadership Financial Data /Claims
Clinical Leadership Experience Health Alignment
Effectiveness Management
Sharp
AprilHealth
21, 2021
Plan | sharphealthplan.com Sharp Health Plan | Confidential – not for public distribution 26Highest member-rated health plan
Sharp Health Plan is the highest member-rated in California
among reporting California health plans for:
Health Plan | Health Care | Personal Doctor | Specialist
* To learn more about our accolades, go to sharphealthplan.com/honors.
Sharp
AprilHealth
21, 2021
Plan | sharphealthplan.com Sharp Health Plan | Confidential – not for public distribution 27Customer leadership position in the market
Member Employer Broker Provider
90th 91% 93% 90th
percentile member overall employer overall broker percentile provider
satisfaction satisfaction satisfaction satisfaction
Sharp
AprilHealth
21, 2021
Plan | sharphealthplan.com Sharp Health Plan | Confidential – not for public distribution 28Sharp HealthCare access
Sharp Health Plan is Covered California’s
only full access to Sharp HealthCare and
Sharp Medical Groups
Sharp
AprilHealth
21, 2021
Plan | sharphealthplan.com Sharp Health Plan | Confidential – not for public distribution 29Network Comparison
Performance Premier
Sharp Rees-Stealy Medical Group X X
Medical Sharp Community Medical Group X X
Groups Sharp Community Medical Group - Arch X
Sharp Community Medical Group - Graybill X
Sharp Community Medical Group - Graybill Temecula X
Sharp Community Medical Group - Inland North X
Rady Children’s Health Network / Children’s Physicians Medical Group X
Palomar Medical Center X X
Palomar Medical Center Poway X X
Rady Children’s Hospital (2 locations) X X
Sharp Chula Vista Medical Center X X
Sharp Coronado Hospital and Healthcare Center X X
Hospitals Sharp Grossmont Hospital X X
Sharp Mary Birch Hospital for Women & Newborns X X
Sharp Memorial Hospital X X
Sharp Mesa Vista Hospital X X
Temecula Valley Hospital X X
Inland Valley Medical Center X
Rancho Springs Medical Center X
April 21, 2021 Sharp
SharpHealth
HealthPlan
Plan | | 1-858-499-8300
Confidential – not
| for
sharphealthplan.com
public distribution 30We’ve got you covered
Around town, across the world, and around the clock.
SMS / Text Reminders Emergency
Travel
Hospitals & Video Visits / TeleHealth Urgent Care Facilities
Services
Emergency Rooms
After-Hours Nurse Line MinuteClinic
Primary &
Online Portals
Specialty Care
Health Coaching
Pharmacy Partners Wellness
April 21, 2021 Sharp
SharpHealth
HealthPlan
Plan | | 1-858-499-8300
Confidential – not
| for
sharphealthplan.com
public distribution 31Get the care you need, when you need it
To access the latest information regarding getting the care you need while
staying safe, we invite you to visit sharphealthplan.com/covid19, our
dedicated COVID-19 resource center
After-Hours Nurse Advice
Registered nurses are available through Sharp Nurse
Connection® after hours and on weekends. They can talk with
you about an illness or injury, help you decide where to seek care
and provide advice on any of your health concerns.
MinuteClinic®
MinuteClinic is the walk-in medical clinic located inside
select CVS Pharmacy® stores. MinuteClinic provides
convenient access to basic care without an appointment.1
Video and phone visits
Get the care you need from wherever you are with a video or
phone visit, also known as telehealth. Call your PCP’s office
for the latest telehealth service information.2
1 Your share of the cost for a MinuteClinic visit is equal to what you pay for a PCP office visit (deductible may apply). There is no copayment for flu vaccinations
2 Select doctors offer this service. Please note, telehealth is not available for all services, please contact your primary care physician to learn more.
April 21, 2021 Sharp
SharpHealth
HealthPlan
Plan | |1-858-499-8300
Confidential – not
| for
sharphealthplan.com
public distribution 32Sharp Health Plan Vaccine Support
Sharp Weekly Email Updates
Sharp Vaccination Program Update
Sharp has administered 360,916 first and second doses of the COVID-19 vaccine
to employees, providers, patients, volunteers and community members. That’s
an increase from last Friday’s total of 326,892 doses administered. To date,
Sharp vaccination centers have administered COVID-19 vaccines to
approximately:
20,800 Sharp team members
30,000 educators
215,800 patients and area residents
www.sharphealthplan.com/covid-19
April 21, 2021 Sharp
SharpHealth
HealthPlan
Plan | | 1-858-499-8300
Confidential – not
| for
sharphealthplan.com
public distribution 33Grossmont Center/Vaccine Support
Sharp
AprilHealth
21, 2021
Plan | sharphealthplan.com Sharp Health Plan | Confidential – not for public distribution 34Chula Vista/Vaccine Support
Sharp
AprilHealth
21, 2021
Plan | sharphealthplan.com Sharp Health Plan | Confidential – not for public distribution 35American Recovery Plan Support Plan
· How the Plan is promoting extended SEP enrollment through May
· Reaching out to Sharp members list of Non Payment
· Reaching out to brokers member list of Non Payment
· Contact all Off Exchange members
· Employer Groups Individuals list of Non Payment
· Continued efforts with Sharps Medical Groups and ARP
Sharp
AprilHealth
21, 2021
Plan | sharphealthplan.com Sharp Health Plan | Confidential – not for public distribution 36Sharp’s IFP Team
Consider us your personal
health care assistant®
Kelly Johnson Trent Fields Trisha Maatubang Georgina Herrera
Account Executive Account Executive Sales Associate Sales Associate
Sharp Health Plan Covered California (subsidy-eligible)
sharphealthplan.com CoveredCA.com
1-858-499-8211 1-800-300-1506
April 21, 2021 Sharp
SharpHealth
HealthPlan
Plan | | 1-858-499-8300
Confidential – not
| for
sharphealthplan.com
public distribution 37Thank You!
CHINESE COMMUNITY HEALTH PLAN
(CCHP)
Wil Yu
Chief Operating Officer
39Virtual Statewide Carrier Meeting April 20, 2021 hello@cchphealthplan.com
San Francisco
San Mateo
South San Francisco
Daly City
San Bruno
A Local Health Plan for
Brisbane
Colma
San Francisco and San Mateo Counties Burlingame
Millbrae
San Mateo
Foster City
Hillsborough
Pacific
Half Moon Bay
Belmont
San Carlos
Exclusive Community Joy of Redwood City
Local Focus First Health and Wellness
Menlo Park
130-year old, not-for-profit healthcare system
hello@cchphealthplan.comBalance – Higher Value, Lower Cost
• HMO Product
• Priced and adapted for the Local COVID19 Economy
• Easier Access to Care
• Care Coordination of Integrated System
hello@cchphealthplan.comPhysicians
Hill Physicians
One Medical
Jade Medical Group
Balance Providers - Choice & Flexibility Hospitals &
Care Facilities
UCSF
• 7,000+ Physicians in-network Sutter
• Diversity - High % Bi-lingual, fully fluent Dignity Health
Chinese Hospital
• Network designed to mirror our members Seton
• Wide range of San Francisco, San Mateo Sequoia
Stanford Hospital
County hospitals
hello@cchphealthplan.comSensitivity to Culture
• Over 60% of CCHP’s enrollees identified a
non-English language as their primary language
• Languages represented include Chinese
(Cantonese and Mandarin), Spanish,
Vietnamese, Tagalog, Japanese, and Korean
hello@cchphealthplan.comCOVID-19 Engagement for the Community
• Extensive outreach with cultural and
language sensitivity
• Premium Reduction and Cost Sharing
Waiver
• COVID – 19 Testing
• COVID – 19 Vaccinations
hello@cchphealthplan.comBalance Plans are now more affordable for More
Members!
• Due to American Rescue Plan Subsidy and New Open
Enrollment Period through rest of year
• We will respond with:
• In-person Member Services &
multi-cultural Open Enrollment Centers
• Increased Advertising Media in multiple language
• Urgent Member Communication
hello@cchphealthplan.comVALLEY HEALTH PLAN
Ashley Bejarano
Sales & Broker Relations Manager
47WESTERN HEALTH ADVANTAGE
Michele Lehuta
Government Programs Director
65AUTO TRANSITION
MAIN ROOM
FOR MEETING CLOSURE
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