2023 Community Report Investing in YOU!
Dear Constituents, Colleagues, and Friends, It is with great pride that we share our 2023 Community Report. For more than 25 years, Kern Health Systems has celebrated many milestones, most notably the continued dedication of our employees, providers and community partners to provide equitable health care to Kern Family Health Care members. Many of the achievements outlined in this "Investing in You!" publication would not have been possible without your collective partnership. With a commitment to quality, Kern Health Systems works diligently to provide the health care that many underserved residents of Kern County need. The impact of our partnership on the lives of our members is illustrated throughout this publication. We are extremely proud of our collaboration with you and hope you are pleased with the growth and diversity of our programs, services and membership. As we continue to invest in you, we look forward to a lasting partnership of innovation and achievement. Together, we can continue to enhance member access and strengthen the health and well-being of our members and community–because everyone deserves a better day. In good health, Kristen Beall Watson, EdD Chairman Kern Health Systems Governing Board Emily Duran, MS Chief Executive Officer Kern Health Systems 1
Kern Health Systems, the county health authority, is an independent public agency that governs Kern Family Health Care. The Board of Directors is appointed by the Kern County Board of Supervisors and includes major health care stakeholders, including physicians, safety-net providers, hospitals, pharmacies and community representatives. Board meetings are held every other month and are open to the public. Kristen Beall Watson, EdD Chairman Third District Community Representative Scott Thygerson Vice Chairman Kern Medical Representative Vijaykumar B. Patel, MD Secretary Rural PCP Representative Ross Elliott Treasurer First District Community Representative Sarabjeet Singh, MD Urban PCP Representative Timothy McGlew Rural Hospital Representative Olga Meave, MD Safety Net Provider Representative Kimberly Hoffmann, PharmD, BCPP Pharmacist Representative Michael T. Bowers First District Community Representative Alex Alva Second District Community Representative Jay Tamsi Third District Community Representative Ganesh Acharya Fourth District Community Representative Albert Ma, MD Fifth District Community Representative Michael Turnipseed Fifth District Community Representative Governing Board 2
3 Our Vision “To transform Kern County into a community where everyone has the opportunity to realize a healthier, happier life.” Our Mission “Health and equity for all.” Our Core Values
Investing in Our MEMBERS Members are satisfied with Kern Family Health Care, and our dedication is reflected in the results of the 2023 Member Satisfaction Survey. In the health plan rating domain, Kern Family Health Care ranked in the 96th percentile—significantly higher than in the previous two years—and achieved a 72 percent overall satisfaction rate. This surpasses the 60.7 percent benchmark for similar plans in Region 9, surveyed nationwide in 2023. In 2023, KHS experienced significant growth in leadership, staff and membership—now serving over 90 percent of Medi-Cal beneficiaries in Kern County. We expanded our provider network, added new services and programs, and collaborated with the Kern County Department of Human Services to streamline data sharing during the Medi-Cal renewal process. This partnership helped us quickly address coverage gaps, 4
Member Experience and Satisfaction safeguarding our members' health and well-being. Key projects that demonstrated our commitment to members included: aDeveloping a Medicare Dual-Eligible Special Needs Plan, which we’re preparing to launch in 2026. aHelping many homeless individuals secure permanent housing and funded mobile clinics dedicated to street medicine services. An estimated 400 mobile health clinics will be strategically positioned throughout Kern County. aExpanding the Enhanced Care Management (ECM) program by adding 31 new programs across Kern County. The ECM program also introduced three new Populations of Focus. aContinual expansion of the Transitional Care Program to reduce preventable hospital readmissions. aEstablished doula services as a new preventive benefit on Jan. 1, 2023. aAdded six community supports services, increasing the total to 14. This included coordinating resources to address social determinants of health with 12 of the 14 DHCS-approved services available through a network of community-based organizations. aExpanding services to include Ridgecrest in Eastern Kern County. Patient 2023 KHS 2023 SPH BoB Performance Experience Summary Rate (%) Region (%)* Indicator Rating of Health Plan 72.0% 60.7% GJ Rating of Health Care 61.5% 53.5% GJ Rating of Personal Doctor 71.6% 65.1% GJ Getting Needed Care 84.5% 78.4% GJ Getting Care Quickly 80.7% 75.4% GJ Customer Service 91.6% 88.2% GJ Coordination of Care 82.7% 83.6% FK How Well Doctors Communicate 92.5% 91.1% GJ *SPH Analytics/Press Ganey Book of Business benchmark of regional health care plans which is heavily weighted by California health plans. 5
KHS recognizes that a strong quality performance program is vital for a successful managed care plan. KHS developed and implemented quality improvement (QI) systems and processes to monitor, evaluate, and enhance the quality and safety of care provided by contracting providers. These efforts ensure that all aspects of health care delivery comply with applicable standards and regulations. The QI program actively monitors and assesses the quality, appropriateness, safety and outcomes of the health care services delivered by contracted providers to Kern Family Health Care members. In 2023, KHS introduced a health equity program designed to integrate with the QI program. This initiative assesses needs based on geographical location, race, ethnicity, language, cultural preferences, health disparities and stakeholder engagement. Understanding health disparities is key to identifying differences in care provided to members of various racial, ethnic, or cultural groups that cannot be explained by underlying health conditions or patient preferences. KHS continues to implement programs to monitor, assess and enhance health care services to reduce disparities within its membership. Investing in QUALITY PERFORMANCE 6
Managed Care Accountability Set (MCAS), a California-specific set of performance measures derived from HEDIS, is organized into domains such as chronic disease management, behavioral health, cancer prevention, reproductive health and children’s health. MCAS scores are essential not only for measuring the performance of health plans and providers but also for giving insight into the health and wellness of Kern Family Health Care members. The monitoring, access and utilization of services by members are the most important indicators of overall health, disease prevention and the quality of care provided to our community. The higher the MCAS scores, the healthier our community and members, which directly supports the KHS mission. Satisfactory MCAS scores are determined by the Minimum Performance Level (MPL), set by the Department of Health Care Services (DHCS) and based on the National Committee for Quality Assurance’s (NCQA) 50th percentile. Achieving these goals requires a strong organizational effort, in collaboration with community partners, providers and members. Providers like Shafter Pediatrics and Vanguard Medical Corporation exemplify KHS's commitment to excellence in care. These providers consistently deliver high-quality, equitable services to children in rural areas and are dedicated to meeting or exceeding MPL’s for most MCAS measures, making significant contributions to the success of KHS. For measurement year 2023, KHS improved performance in 17 of 18 measures, achieved MPL in eight measures, and was one measure away from meeting MPL in an additional category. This would bring the total to nine MPLs met, with one of those measures achieving the high-performance level (HPL) for 2023. 7
Our providers appreciate us! We ranked in the 99th percentile for overall satisfaction compared to similar plans nationwide, and 98.3 percent of our providers would recommend us to their colleagues. Together with 3,600 providers, we have built an accessible network that delivers high-quality care, developed innovative programs that bring the community together, and fostered a collaborative, ethical team culture. Our commitment to the safety net, local physicians, community hospitals and other caregivers grows stronger each year. KHS continues to expand our provider network and has offered financial support to assist our provider partners in various ways, including: aPaying over $900 million to our provider network for medical services. aDistributing approximately $6 million in provider performance incentives. aAllocating $19.3 million through the Housing and Homelessness Incentive Program to 18 local providers and community-based organizations to improve health outcomes, prioritize wholeperson care, address housing insecurity, and reduce homelessness. Investing in Our PROVIDERS 8
Composites/ KHS 2022 2022 National Medicaid Percentile Ranking Attributes Summary Rate Summary Scores (At or Above 75th) Overall Satisfaction 90.5% 71.7% Favorable 99th Other Local Plans 70.8% 41.8% Favorable 99th Compensation 58.3% 37.8% Favorable 96th UM & Quality 64.2% 38.1% Favorable 100th Network/COC 50.6% 34.9% Favorable 95th Health Plan Call Center 64.5% 41.1% Favorable 99th Provider Relations 73.3% 36.6% Favorable 100th Would Recommend 98.3% 87.7% Favorable 98th 9 aParticipating in a three-year (2022-2024) CalAIM Incentive Payment Program to expand enhanced care management and community supports which: l Allocated $14.7 million in performance-based incentive funding for Program Year 2 (2023). l Awarded funding to 10 providers and community-based organizations. In August 2023, the Kern Health Systems Board of Directors approved $20 million in grant and strategic initiative funding to support health equity goals by expanding access to care in rural communities, improving care quality and increasing provider capacity. aImplementing two provider grant programs and two strategic initiatives from 2023 to 2025 aimed at enhancing care quality and expanding the health care workforce: l Provider Grant Programs ($8 million): m Provider Recruitment and Retention Program: $3 million m Quality Grant Program: $5 million l Strategic Initiatives ($12 million): m Health Care Workforce Expansion Program: $10 million m Community-Based Organization Program: $2 million Provider Experience & Satisfaction Survey conducted by SPH Analytics/Press Ganey
2023 was a year of exceptional job growth for Kern Health Systems (KHS). We ended the year with 608 employees, ready to serve more than 400,000 Kern Family Health Care members in 2024. As part of our commitment to providing the best service to our members, we launched five newly formed departments and divisions in 2023. These include behavioral health, health equity, population health management, member engagement and quality performance. By strategically expanding our services, we are improving access to quality health care and providing a more personalized experience for our members. This has resulted in high member satisfaction, increased efficiency and better health outcomes for Kern County. Investing in Our EMPLOYEES 10
As KHS grows, so does our commitment to diversity, equity, inclusion and belonging. Our workforce continues to diversify at all levels, and we are proud to attract and hire employees from various backgrounds and underserved communities, creating a workforce that better reflects our county’s diversity. Many KHS employees, who are either former Kern Family Health Care members or personally know a member, are deeply committed to bridging gaps in care so that our members receive the quality health care they deserve. In addition to our commitment to our members, we are equally dedicated to providing the best workplace experience for our employees. We offer competitive salaries, low employee contributions to medical premiums, tuition reimbursement and many other benefits, resulting in a happier workforce. Retention Employees report high likelihood of remaining at KHS in the next year. Discretionary Effort Employees demonstrate willingness to work above and beyond expectations. Alignment with Objectives Employees feel their work supports strategic and departmental goals. Shared Purpose Employees are aligned with KHS's mission and shared vision. KEY STRENGTHS 11
Our community partners are essential in helping us deliver wellness-based health care services to local neighborhoods. Together, we share a vested interest in improving our community. Community Grants The community-based grant program awards financial support to local nonprofits dedicated to enhancing the lives of Kern County residents. Now in its ninth year, the program has granted a total of $313,026 to 77 organizations for their innovative efforts in serving the community. 12
13 Some of the programs KHS is proud to support this year include: aArvin Navigation Center (Flood Ministries) aBlack Infant and Maternal Health Initiative aButtonwillow Family Resource Center aChurch Without Walls Oildale aComunidades Aliadas Tomando Acción aEast Kern Family Resource Center aFrazier Park Family Resource Center The community-based grant program continues to recognize the vital role these organizations play in our health care delivery system, providing financial support to groups serving Medi-Cal beneficiaries and lowincome populations. Partnerships Our ongoing collaboration with partners like Clinica Sierra Vista, which has established a regular schedule of mobile units across the county to break barriers to care for school-aged children and their families, and Community Action Partnership Kern, whose resource centers offer critical support to our members and the community, strengthens our efforts to combat health access disparities. “I can’t tell you enough how awesome it is having partners who help us achieve the greatness we strive for in our community. We have gained ground like no other this year and our garden space is so much more accessible, maintained, and absolutely stunning from us applying the grant we were awarded.” — Apple Core Project Inc. aLamont/Weedpatch Family Resource Center aNo Sister Left Behind aOasis Family Resource Center aThe Open Door Network aRichland School District aStay Focused Ministries aTransitional Youth Mobilizing for Change
The two-year School Wellness Grant Program aims to engage students, parents and school staff in activities that promote and support the physical, social, emotional and behavioral well-being of students and their families. This year, grant funding was awarded to schools representing the north and south Kern communities, the Kern River Valley and Bakersfield. The awarded schools include Alicante Elementary, Fred L. Thompson Junior High, Harvest Elementary, Horizon Elementary, Kernville Elementary, Louise Sandrini Elementary and Woodrow Wallace Middle School. Investing in Our YOUTH 14
15 Each school’s wellness program is tailored to meet the specific needs of its students, with input from parents, staff and community partners. Programs focus on key areas such as nutrition, physical activity, social-emotional learning and vaping prevention. Planned activities range from school gardens and group sports to meditation, healthy cooking classes and family educational initiatives. Past grant-funded efforts have included running clubs, classroom meditation and water stations, all aimed at building a healthier future for students and their communities. In addition to these efforts, KHS supports the Student Behavioral Health Incentive Program, with participation from eight districts. A notable partnership is with the Lamont Elementary School District, which has established wellness centers in every school, mobile unit events and behavioral health initiatives. Lamont's proactive approach includes providing space for KHS’s community engagement team to connect with families, utilizing outreach methods to engage parents and families effectively. KHS also sponsored a two-day vision clinic at Delano Union School District, a Tdap clinic at Bakersfield City School District, tobacco prevention education classes through Dignity Health's Community Wellness Program, and provided 20 youth scholarships through Gameday Sports Academy. Providers Do Their Part Beyond health care access, providers like Dr. Dixon, of the Children's Clinic of Bakersfield, are also investing in the future of our youth by supporting school wellness programs and initiatives that address the broader health needs of the community. As part of the Equity and Practice Transformation Program and a pilot clinic for the Institute for Healthcare Improvement/California Department of Health Care Services Child Health Equity Collaborative, Dr. Dixon offers after-hours and weekend appointments to ensure children get the care they need.
KHS is transforming care for its members through the Community Supports Services (CSS) and Enhanced Care Management (ECM) programs, which launched in January 2022 as part of the California Advancing and Innovating Medi-Cal (CalAIM) initiative by the California Department of Health Care Services (DHCS). ECM takes a whole-person, interdisciplinary approach to care, addressing both clinical and non-clinical needs of high-cost, high-need members through community-based, person-centered care management. The ECM program grew significantly in 2023, with the number of providers increasing from 10 at launch to 29 by year’s end. Kern County also ranked No. 1 in ECM penetration rates for January-December 2023, outperforming other counties, according to DHCS reports. Kern County had 10,811 (2.35 percent) members enrolled in ECM out of a total 460,136 Medi-Cal managed members. KHS ranked No. 3 overall in ECM penetration rates at 2.67 percent, and No. 3 for ECM among child and youth populations (under 21) with 0.48 percent. In 2023, KHS offered 12 of the 14 pre-approved CSS services, such as housing transition navigation, recuperative care, medically tailored meals and asthma remediation. Partnerships with community-based organizations also expanded, with many adding new services or locations. Between Jan. 1 and Oct. 31, 2023, KHS identified 8,921 members as homeless or at risk of homelessness. Of those, 1,458 received housing navigation services, 80 received housing deposit assistance, and 194 received housing sustainability services after being housed. Additionally, 99 members received recuperative care and 69 received short-term post-hospitalization care. These initiatives, aimed at modernizing Medi-Cal, underscore KHS’s commitment to improving health outcomes and meeting the complex needs of vulnerable populations in Kern County. Investing in REFORMING AND MODERNIZING MEDI-CAL 16
8000 7000 6000 5000 4000 3000 2000 1000 0 Q4 2022 Q1 2023 Q2 2023 Q3 2023 Q4 2023 4500 5288 6164 7076 7850 Enhanced Care Management Census Perspective From a Lead Care Manager “When I first met the member last December, he was homeless, living in his truck and struggling to get by. It was a harsh winter and he had no money for gas or even basic identification. After connecting him with resources like food assistance and guidance on replacing his IDs, he found the strength to make significant changes in his life. Now, he has two part-time jobs and just moved into his own apartment. While he achieved this on his own, he mentioned that our conversations lifted his spirits and kept him accountable. Witnessing his transformation has truly inspired me as a community health worker.” 17
KHS established two new scholarship funds at California State University, Bakersfield, one for nursing majors and the other for students pursuing a Master of Social Work (MSW). These scholarships aim to help students complete their degrees and enter the local health care workforce. The Kern Family Health Care Nursing Annual Scholarship Fund will provide scholarships to four CSUB nursing students each academic year, while the MSW Annual Scholarship Fund will award two scholarships annually. KHS also launched a new scholarship program to support Bakersfield College nursing students. This marks the first time KHS is funding scholarships, with the goal of increasing the number of graduates in nursing and social work. By helping to alleviate the shortage of health care professionals in Kern County, these scholarships will contribute to improving care for Kern Family Health Care members. Investing in EDUCATION AND WORKFORCE
Investing in the FUTURE 19 In our ongoing commitment to creating a healthier Kern County, KHS is focused on expanding services and strengthening partnerships to ensure that every Kern Family Health Care member receives the care they need. KHS is dedicated to ensuring that our partner providers and community-based organizations achieve meaningful progress and effectively address care gaps in our community. Looking ahead, KHS is committed to growing our provider network, with a focus on youth, pediatrics, pregnant and postpartum individuals. We will also continue expanding our enhanced care management sites and community support services to address the medical and social factors that affect the health of our members and the community at large. KHS remains committed to investing in our employees, members, providers and community as we work toward building a more equitable future for everyone in Kern County!
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“We will continue to invest in our members, our community, our providers and our employees creating value for all!”
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