How a Trojan is delivering quality health care to the chronically disadvantaged

Working with local public health agency L.A. Care, a determined USC student is on a mission to provide quality health care to vulnerable community members.

Health care delivery continues to be a hot topic in the U.S. and around the world. Many USC students, faculty and alumni work each day towards improving the quality and reach of health care in this controversial field. Master of Public Health student Diana Brown has set her sights on improving health care for Los Angeles’ most vulnerable populations. Below, she shares her insights working with L.A. Care, an independent public agency created by the state of California to provide health coverage to low-income LA County residents.

What inspired you to get involved in health care delivery?

One of the core courses in the MPH program at USC addresses contemporary issues in the current health system and health reform in the U.S. In this class, I was able to exercise my analytical skills and explore how these systems work together or fail to solve critical health problems. Likewise, this course introduced me to the basic components of health care financing and alternative payment methods compared to the current system. This experience served as a platform to further pursue my interests in health policy and its influence on health care delivery. Furthermore, I enjoy being challenged to think critically about interdisciplinary and innovative approaches to health care.

What are your goals in health care delivery?

My passion for public health is deeply rooted in a desire to serve marginalized, socioeconomically disadvantaged communities whose health and access to care is disproportionality compromised due to circumstances and limitations that are beyond their control. My goal is to utilize my current knowledge and skills in health policy to be an ongoing participant in the efforts to improve health care delivery in the U.S. and promote future health reform.

What types of activities does your work entail?

I currently work at L.A. Care Health Plan, where our department supports a variety of the organization’s initiatives, such as Pay for Performance (P4P), Whole Person Care, Housing for Health, and Health Information Technology advancement. L.A. Care is committed to improving the quality of health care provided to vulnerable groups, and highly emphasizes a team-based work environment, which is one of the many reasons I enjoy what I do. Daily, I interact with top executives and leaders from Anthem, Kaiser and Care1st to ensure that our Medi-Cal members receive quality health care. Additionally, I work to support internal business leads on projects, such as the ones listed above, from concept to implementation stages and maintain strong interpersonal relationships with both internal and external business units.

Have you seen improvements in care quality during your time with L.A. Care?

I have been at L.A. Care a little more than six months, and I continue to observe positive outcomes on many of our projects as time progresses. Our P4P initiative has been highly successful, and is well known among Medi-Cal providers in LA County. As a result, L.A. Care has now taken steps to align their incentives program with P4P, and will further leverage this program to incorporate auto assignment methodology, where our contracted health plans are assigned a percentage of members based on how well they perform in our P4P domains that year. The goal of this initiative is to continuously engage with providers to increase their overall performance, and move towards value based contracting with high performing providers, whereas low performers are filtered out. Additional progress includes L.A. Care’s receipt of a $20 million grant to secure permanent supportive housing for homeless individuals over the next five years, and a proposal to expand the number of family resource centers in LA County from five to 12 by 2020. Family resource centers are community based health centers that offer free classes on healthful cooking, diabetes management, family-oriented Zumba, Pilates, yoga, parenting tips and social service programs, as well as early education activities like group readings and arts and crafts for kids.

What sorts of action has health care delivery seen recently?

Health care is currently a hot topic in different levels of government across the nation, and remains highly politically charged. Throughout 2017 there was tremendous action to defend the Affordable Care Act and fight off proposals to block grant Medi-Caid, limit coverage for individuals with preexisting conditions and resist the reallocation of money from the poor to the wealthy via distortions in premium payments. Moving forward, legislation aiming to improve health care should inevitably focus on affordability, accessibility and quality. Around this time last year, our president claimed, “Nobody knew health care could be so complicated.” Except we did, and there is clearly a great deal of work that is still needed, and will likely extend far into the future.

Why is now a time for change, and what are the consequences of doing nothing?

Given the current political climate, it has never been more paramount to protect the numerous vulnerable communities that are systematically and adversely impacted by limited health care access. We live in an era of ever changing proposals for health care reform, and it is crucial for everyone to remain informed on the potential impacts of policies and legislative proposals that could substantially alter the state of health care we have been working so hard to build and sustain. Failure to speak out and stand up against actions that will leave millions of Americans without care and vulnerable will put innocent lives at risk.

Who should be concerned about health care delivery?

This issues touches everyone in some way shape or form. Sickness and health implications know no boundaries, and it is our responsibility as a nation to ensure that everyone has the right to receive high quality care. Sadly, socioeconomically marginalized communities continue to remain high risk. Likewise, they are the groups that require/benefit from care the most.

What can the public do to get involved?

I highly encourage everyone to remain knowledgeable and share insightful articles on social media platforms to spread the message. Vote in general/local elections for representatives that prioritize health care issues, and are committed to advancing policies that benefit high-risk populations. Call your district and state representatives to voice your opinion, engage in conversation with those who may not necessarily share the same views as you and utilize the information that you gather to dispel common misconceptions politely and professionally. In order for action or compromise to occur, parties with conflicting views need to feel like they are being heard, and proponents can work to craft innovative proposals and solutions.

To learn more about L.A. Care and the services, programs, or careers it offers, visit www.lacare.org. Join the conversation on social media with the hashtag #AdvancePublicHealth!