Our Commitment to Innovation
Inland Empire Health Plan (IEHP) has continued to innovate and meet the healthcare needs of our Members for more than two decades. With our Strategic Priorities guiding us, we will continue to seek opportunities for innovation and improvement – putting access to quality healthcare and our Members, Providers and Community above all else.
IEHP’s innovative Network Expansion Fund (NEF) was the first program of its kind in the state. Established in 2014, the NEF allocates $30 million in specially designated funds to attract board-certified PCPs, Specialists and mid-level Providers to the Inland Empire, addressing the region’s chronic Provider shortage and improving access to care for more than 1.2 million IEHP Members. To date, more than 280 Providers have been recruited as a direct result of this program.
Behavioral Health Integration Complex Care Initiative
The Behavioral Health Integration Complex Care Initiative (BHICCI) is a collaboration between IEHP and more than 30 clinics in the Inland Empire that provides a footprint for the California Department of Health Care Services (DHCS) Health Homes Program, going live January 1, 2019. The goal is to improve Members’ health outcomes by staffing a complex care team to provide comprehensive care management and by coordinating complex physical and behavioral health needs across multiple Providers and health care systems in Riverside and San Bernardino counties. BHICCI care teams are currently transitioning into community-based care management entities (CB-CMEs) that provide Health Homes services in preparation for Health Homes go-live.
Health Homes Program
The Health Homes program (HHP) is an integrated care management program for patients with complex needs that builds on IEHP’s Behavioral Health Integration Complex Care Initiative (BHICCI), as legislated by the Department of Health Care Services (DHCS). The HHP coordinates the physical, behavioral, and community-based Long-Term Services and Supports (LTSS) needs of Members with severe chronic physical and/or mental health conditions. The primary goal of HHP is to improve the overall health outcomes of members through the delivery of care coordination and complex care management. Since the launch of the program in January 2019, more than 9,000 Members have seen overwhelmingly positive clinical health outcomes related to blood pressure, diabetes and depression. Click here to learn more about the Health Homes Program.
EHR and Health Information Exchange
IEHP has partnered with the San Bernardino County Medical Society and the Riverside County Medical Association to form the Inland Empire EHR Resource Center, to assist Providers and clinics in selecting and implementing electronic health record systems. Additionally, IEHP was part of the Inland Empire Health Information Exchange, which merged with the CalIndex Health Information Exchange to form Manifest Medex (MX). MX is a statewide health information exchange that has significant penetration and use in the Inland Empire, with all Inland Empire acute care hospitals and many medical groups and Physicians contributing patient clinical and administrative data. MX brings needed technology to access and securely share electronic patient health records for most of the 4.4 million people living in the Inland Empire. It allows Doctors, clinics, hospitals and other health care Providers to electronically review and access medical records, resulting in timely and improved quality of health care for patients in our community.
This innovative program provides another option for Members to receive medical advice after hours from a Physician. IEHP Members can speak to a board-certified Physician by phone or via video chat, quickly and easily. The Physician can access the IEHP formulary and the IEHP Pharmacy Network to e-prescribe medications for IEHP Members if needed. When fully implemented, this service will enhance Member access and convenience while reducing unnecessary emergency room and urgent care visits.
IEHP is supporting the expansion of telehealth services throughout the Inland Empire, to improve access to critically needed specialty care and to aid in rapid diagnosis and treatment. Telehealth eliminates one of the Inland Empire’s longstanding barriers to care – geographic distance to health care resources. With telehealth’s information and communication technologies, the treatment and prevention of disease or injury can occur long-distance, erasing geography as a critical factor impeding care. Telehealth can also be used to support Provider training and Member education. IEHP is currently supporting telehealth for certain services: behavioral health, retinal examinations, dermatology, and orthopedic consultations. Plans are underway to expand to additional services in alignment with Member needs.
eConsult, a collaboration among IEHP, Arrowhead Regional Medical Center and Riverside University Health Care System, allows PCPs to connect directly with specialists electronically when a patient may need a specialist referral. Through a private, secure system, PCPs can receive timely clinical advice from specialists that may allow them to manage a majority of patients in the primary care setting (some patients may need a face-to-face visit with a specialist). IEHP is sponsoring the initiative for the first 24 months and will design, implement and evaluate eConsult at more than 70 clinic sites throughout Riverside and San Bernardino counties.
Secure Online Member Portal and App
IEHP Members can take an active role in managing their own health 24/7 via a secure online account that can be accessed through the IEHP website or mobile app. Members can view and print their IEHP Member Cards; view lab tests, Immunization Cards and authorizations; find or change Doctors; search the Provider Directory; enroll in health education classes; check eligibility; and more. The separate Baby-N-Me prenatal care app helps improve maternity health outcomes by making it easy for expectant moms to track pregnancy milestones, identify health issues, and stay healthy with reminders and helpful tools.
Texting and Alerts
IEHP uses two-way texting and Short Message Service (SMS) alerts to educate Members about their plan benefits and how to navigate the health care system. These alerts are targeted approaches that communicate seasonal health information about topics such as immunizations, preventive care, medication adherence, and new health plan features.
Long-Term Services and Supports (LTSS)IEHP’s Long-Term Services and Supports (LTSS) program enables seniors and persons with disabilities to live independently in their homes as long as safely possible, and provides care in a Skilled Nursing Facility (SNF) when they cannot. LTSS includes the Multipurpose Senior Services Program (MSSP) and Community-Based Adult Services (CBAS), as well as SNF services when required. IEHP also helps coordinate any In-Home Supportive Services (IHSS) benefits. Since May 2018, IEHP has helped transition 750 Members out of long-term care facilities and back into the community. A 24-hour in-home emergency caregiver program and a case management program, developed in partnership with the Riverside County Department of Social Services, received the 2017 and 2018 Achievement Award from the National Association of Counties. IEHP has also partnered with the University of California, Los Angeles on a Geriatric Workforce Enhancement Program to provide patients, families and caregivers with the knowledge and skills they need to improve health outcomes and increase the quality of care for older adults.
At IEHP, quality means focusing on the healthcare needs of our members and supporting our providers. We are committed to quality, driving us to create programs and services to meet the needs of our members and providers.
In fact, IEHP is one of the top-rated Medicaid plans in California. Determined by both the Healthcare Effectiveness Data and Information Set (HEDIS) and the Consumer Assessment of Healthcare Providers and Systems (CAHPS), NCQA has awarded IEHP an Accreditation status for Medi-Cal. This status is only given to health plans that have clinical and service programs that meet or exceed NCQA standards.
Learn more about how IEHP delivers quality services and care below.
Inside the 2020 Quality Report, we take you through our quality journey by looking at our performance over the past year with critical measures. We show you how that data translates into tangible outcomes for our Members, Providers and Team Members. While there were many areas where we excelled, there were also places where we found opportunities for improvement.
The goal of this Quality Report is to be transparent—with you and with ourselves. This journey is ongoing, and we hope to learn from it so we can do better and be better for those who rely on us the most.
IEHP supports an active, ongoing, and comprehensive quality management program with the primary goal of continuously monitoring and improving the quality of care, access to care, patient safety, and quality of services delivered to IEHP Members. The Quality Management (QM) Program provides a formal process to systematically monitor and objectively evaluate, track and trend the health plan’s quality, efficiency and effectiveness.Quality Management Evaluation
Every year, IEHP assesses the overall quality of health care experienced by IEHP members. To achieve this IEHP uses NCQA, a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and manages the evolution of HEDIS® which provides:
- a set of standardized performance measures based on statistically valid samples of members
- the public with information to compare health plan performance
IEHP values a strong partnership with our providers. To support them we offer many services from online support, to a call center, to a dedicated service representative. That's why doctors think highly of IEHP. In fact, according to the 2019 Provider Satisfaction Survey conducted by SPH Analytics, 98.5% of physicians would recommend IEHP to other physicians.
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