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Gold Coast Health Plan Receives Two Managed Care Quality Awards

Corporate news | Tuesday, November 26, 2019

Contact: Susana Enriquez-Euyoque

CAMARILLO, Calif., November 26, 2019 – For the second year in a row, Gold Coast Health Plan (GCHP) has been recognized by its state regulator for improving health care quality for Medi-Cal beneficiaries.

The Managed Care Quality and Monitoring Division of the state Department of Health Care Services (DHCS) recognized GCHP with two Quality Improvement awards. The Greatest Overall Improvement in One Year award is given to the managed care plan with the most significant improvement from the prior year based on its performance across all measures for which DHCS holds plans to minimum performance levels.

The Plan also received the Quality Strategy Focus Areas Most Improved Award for its work in four areas: Comprehensive diabetes care, controlling high blood pressure, childhood immunizations, and prenatal and postpartum care.

"These awards reflect the excellent care our members are receiving from our providers," said Dr. Nancy Wharfield, GCHP's chief medical officer. "They are also a testament to the ongoing commitment of our quality team to continuously improve the Plan's data collection efforts."

GCHP quality scores now rank 20th among the 53 health plans that have Medi-Cal managed care lines of business in California – up 30 spots since the 2017 rankings.

"Landing near the top third of the highest-scoring health plans is an outstanding achievement," Dr. Wharfield said. "We are proud of the work that went into getting these results and are focused on ending this year strong."

The Plan saw the most improvement in its quality scores on childhood immunizations and postpartum care. To improve the measure on postpartum care – which measures the percentage of women who had a postpartum visit between 21 and 56 days after delivery – GCHP partnered with Ventura County Medical Center in 2018 to reach out to members who had just delivered their babies there. The Plan's health navigators visited VCMC several times a week to make a connection with the moms and help them schedule their postpartum appointments. They also followed up with them to remind them about their appointments and helped them arrange transportation if they needed it.

The partnership was successful: GCHP saw a 9% increase in the number of moms who received postpartum care in 2018. The Plan performed in the 90th percentile – meaning that the Plan performed better than 90% of all Medicaid plans in this category historically.

"We are focused on improving health outcomes for our members and this partnership with VCMC helped us do that," Dr. Wharfield said. "We look forward to continued partnerships with our providers on other quality improvement projects."

The quality awards were announced at the Oct. 30 DHCS Health Equity Quality Conference in Sacramento. These awards are intended to highlight managed care plans that have excelled in improving health care quality for managed care beneficiaries.

The Managed Care Quality and Monitoring Division is responsible for the monitoring and oversight of all Medi-Cal managed care health plans. Performance monitoring helps the division create appropriate policies for improving the health of beneficiaries and to ensure access to high quality health care for all health plan members.

About Gold Coast Health Plan
Gold Coast Health Plan proudly serves more than 190,000 Medi-Cal beneficiaries in Ventura County through its network of primary care physicians, specialists, behavioral health providers, hospitals, and pharmacies. Since it was founded in 2011, Gold Coast Health Plan has been committed to providing access to high-quality care and improving the health of its members, which include 1 in 5 county residents, 1 in 8 seniors, and 1 in 2 children up to the age of 5. To learn more, visit: goldcoasthealthplan.org.