California Fireside Chat with Secretary Mark Ghaly
April 26, 2022 · Kristine Toppe
California is known around the country and the world for its beautiful geography, vibrant economy and a focus on healthy living. But as Secretary Mark Ghaly shared during NCQA’s Fireside Chat, the opportunity for healthy living has not been realized by many. He blames inequities that systematically impact communities based on a variety of factors including color, age, sexual orientation, and ability status. Dr. Ghaly covered the issue when sat down with NCQA President Peggy O’Kane to talk about his work leading California’s Health and Human Services agency since 2019 and the state’s goals for “raising all boats”.
Dr. Ghaly candidly shared the challenges of overcoming historical state agency silos with a commitment to “silo-busting” so that data could be shared and used to improve the care and experience of people receiving publicly funded services. Under Dr. Ghaly, CalHHS leads by example, tackling cross-sector challenges through initiatives such as the Data Exchange Framework Workgroup, the Master Plan for Aging and the creation of the California Office of Medicare Innovation and Integration. Each are tasked with paving a path forward with policies and solutions that put the whole person at the center.
But the state’s biggest demonstration of that whole-person approach can be seen through CalAIM, which launched in January 2022. The state has set its expectations for health plans to work more closely with the communities they serve. It wants them to collaborate and coordinate with community-based organizations to ensure that people covered by MediCal (California’s Medicaid program) get improved support through new benefits referred to as Enhanced Care Management and Community Supports. These benefits aim to reinforce the importance of evaluating the “whole” person’s needs to support the best health outcome.
The Secretary also spoke openly about the efforts to control drugs costs through new contracting with a single statewide PBM for MediCal, known as MediCalRx. He also reported the state is exploring ways to address the high cost of critical medications such as insulin. Shortly after the Fireside Chat, California announced plans to form partnerships to make the diabetes drug more accessible and affordable and potentially even manufacture the drug itself. California would be the first state to take such aggressive steps as the national conversation on addressing insulin costs continues.
As CalAIM and the state’s other reform efforts continue to unfold, we look forward to reporting back on their successes, challenges and lessons learned. And we can’t thank Secretary Ghaly enough for sharing his insight and perspectives on California’s exciting efforts to improve care.