Affordable Care Act

For Patients

Many of the questions we’ve received regarding the Affordable Care Act (ACA) are from our patients. They want to understand how ACA, health care reform, is going to affect their personal health care. Here are a few typical questions we receive:

Q: “I’m a low-income single adult with no children – one of the so called ‘working poor’ - who gets medical care at my neighborhood health center, how is ACA going to make my health care better?”

A: With ACA, in 2014, a single childless adult making up to 133% of the Federal Poverty Level ($14,484 for 1 person) in California will be eligible for Medi-Cal and they will be covered for hospitalization, where that was not the case previous to ACA.

Q: “My child has what is called a ‘pre-existing condition’ and because of that I can’t add him to my health coverage I get through my job.”

A: By January 2014, families with children who had been refused coverage because of the child’s preexisting condition can no longer be turned down.

Q: “I don’t qualify for Medi-Cal because my income is just a little too high.  Will ACA be able to help me?”

A: For people who are at 133% to 400% of the federal poverty level ($14,484-$43,560) who do not receive employee sponsored health benefits will be able to purchase a full range of insurance coverage, using federal tax credits as a subsidy.

For the Network

SFCCC is actively engaged on a network level. We are implementing a series of trainings for the Boards and Staff of the clinics on the following topics:

  • Improving Patient Experience
  • Health Exchanges
  • Payment Reform
  • Health System Changes
  • Strategic Partnerships

Our Continuous Quality Improvement (CQI) staff is actively engaged in training and supporting SFCCC partner clinics with developing patient centered medical homes (

PCMH

). To date, using the 

Safety Net Medical Home Initiative Self-Assessment Tool

, we have completed surveys on the majority of our clinics. The tool covers six major concepts for achieving patient centered health medical homes:

  • Empanelment (every patient is assigned to a specific Provider or Care Team)
  • Continuous and Team-Based Healing Relationships
  • Patient Centered Interactions; Engaged Leadership
  • Quality Improvement (QI) Strategy
  • Enhanced Access Care Coordination
  • Organized, Evidence-Based Care.

On the survey the clinics rate themselves based on where they are regarding the stages in development toward a patient centered medical home. Results point to two areas where SFCCC can support clinics:

  • Strengthen the patient-provider led care team relationship and its accountability for patient care by implementing patient empanelment guidelines across all SFCCC clinics
  • Enhance the effectiveness of primary care teams by defining roles and assigning patient care tasks appropriate to the staff license and training level of each member of the care team.

The SFCCC Board of Directors is reviewing this tool and clinic-specific outcomes with clinic Executive Teams.  We have already received positive feedback from clinic leadership about the results. We will also be developing network wide and individual clinic training plans based on the survey outcomes. By late summer we will launch a series of interactive workshops that allow clinics to collaborate and problem solve around specific areas where health home activities can be increased. We will keep you posted regarding our progress.