Covered CA Enrollees Accessing Health Care Services

View All Insights »

Covered California recently released its first compilation of data showing the types of care enrollees received in hospitals throughout California between January 1, 2014 and June 30, 2015.  The data was reported by 111 hospitals and hospital systems, which represents approximately 40 percent of all inpatient care delivered by hospitals statewide.

Not surprisingly, Kaiser saw the largest portion of Covered California patients at its numerous campuses throughout the state.  At its Los Angeles Medical Center, 14,388 individuals who were enrolled in a Covered California plan accessed inpatient or outpatient services during that time period, including 496 emergency room visits and 2,2261 mental health visits.  Its San Diego campus saw more than twice that number – a total of 34,168 individual Covered California patients.

Covered California plans to continue collecting data to better understand the care that is being delivered to its enrollees.  It is in the process of launching the Covered California Healthcare Evidence Initiative that will collect utilization data from the health insurance plans it contracts with to better understand the totality of care accessed by its enrollees at all care facilities statewide.  They’ve engaged Truven Health Analytics to help them understand:

  • If people with chronic conditions are getting the right care at the right time,
  • The degree to which individuals are using the free preventive services available under the Affordable Care Act,
  • Whether early intervention is helping people avoid the worst effects of cancer or other life threatening conditions, and
  • The relationship between consumers’ selected benefit design, their ability to pay and access to care.