Uninsured Product Development
Pacific Health Consulting Group helps clients develop products to expand access to healthcare services for under and uninsured populations. PHCG has helped design new products, including defining benefits, premiums and co-pay parameters as well as outreach, enrollment and retention strategies. Healthy Kids and In-Home Supportive Services (IHSS) are among the products PHCG has developed in several counties. Tim Reilly has extensive experience in developing Financial Feasibility Studies and Provider Rate Structures for these programs. PHCG has also evaluated Indigent healthcare programs in a number of counties.
Some of our most recent uninsured product development projects include:
- Santa Clara County
Children's Health Initiative/Healthy Kids Product
As chief consultant for the project, Pacific Health Consulting Group worked closely with Working Partnerships, Santa Clara County and Santa Clara Family Health Plan to: identify the scope of the problem and goal of the project; plan the community enrollment and outreach efforts; develop the insurance product; price the product; work with the client to license the product; and help with outside fund raising plans for the product.
- Sonoma County, Marin, El Dorado, San Luis Obispo County and Del Norte County
As chief consultant, PHCG developed new initiatives in Sonoma, Marin, El Dorado, San Luis Obispo and Del Norte Counties to expand coverage to uninsured children. Project included: developing initial feasibility and financial projections of uninsured children, funding sources and work plans; development of governance and health plan contracting in these non-Medi-Cal managed care counties; and provided on-going advice and counsel related to development and implementation of these new products in these new locations.
- San Mateo County
Pacific Health Consulting Group is working closely with the Hospital Council of San Mateo and San Mateo County to better understand the number of uninsured children and the potential funding sources.
- Alameda County, Santa Clara County and Santa Barbara County
Pacific Health Consulting Group expanded coverage to the IHSS workers who provide in-home support services to the disabled and frail elderly on Medi-Cal. These workers are now insured through new products developed in coordination with the Public Authority and the local public Medi-Cal managed care organization.
New delivery projects for low-income individuals include:
- Developed the County Organized Health Systems in Santa Barbara, San Mateo, Solano and Santa Cruz Counties for Medi-Cal managed care.
- Conducted the initial feasibility analysis for Orange County's County Organized Health System.
- Assisted Santa Cruz's Central Coast Alliance for Health in expanding its geographic area to Monterrey County for Medi-Cal managed care.
- Assisted Partnership HealthPlan of California (Solano) in expanding its geographic area to Marin County for Medi-Cal managed care.
- Developed the local initiatives in Alameda County (Alameda Alliance for Health) and Santa Clara County (Santa Clara Family Health Plan).
- Consulted with Inland Empire Health Plan (Riverside and San Bernardino Counties Joint Powers Agreement) on new product development and expansion of Medi-Cal.
- Developed a new community health center in East Palo Alto, California.
- Worked with community health centers to merge and expand operations to serve low-income areas more effectively. Some of the health centers include: West County Health Centers; Sonoma County (Occidental Health Center and Russian River Health Center); and Mountain Valleys Health Centers in Dorris, Tulelake and Bieber.