Covered California was established as an independent state-based organization with a mission to expand coverage for Californians by creating a consumer-centered marketplace that was anchored in the “triple aim” of better care, lower costs and improved health.
Since opening its doors, we have given consumers the power of choice in a competitive market; kept rate increases far below California’s historical trends; made business sense for health plans by building the healthiest risk pool in the nation; and helped slash our uninsured rate by nearly 10 points, to the lowest level in California’s history.
Policy changes are sure to come, but the lessons we have learned should be part of the discussion for shaping a consumer/patient-centered future for health care. These lessons include how Covered California:
· Built a competitive marketplace that gives consumers choice when it comes to the plans they pick and the providers they can access.
· Developed patient-centered benefit designs that keep care affordable by including a wide variety of services that are not subject to the deductible.
· Fostered a good risk mix by engaging and promoting access to primary care through robust and extensive marketing and community outreach.
· Established an infrastructure to examine patient data to evaluate the relationship between consumers’ income, benefit designs, health status and other factors on the quality of care and costs of services.
These are lessons that can extend well beyond California’s borders. They are relevant for federal and state policy, the employer-based and private health insurance markets. The new administration, Congress and policy leaders in California and nationally should look to our lessons and other on-the-ground efforts across the nation as we as we seek to foster a health care system that works for all Americans.