CalPERS is committed to ensuring high-quality health care and equitable health outcomes are achieved for all members and their beneficiaries, regardless of race, ethnicity, sexual orientation, or gender identity.
To create meaningful change, CalPERS recognizes that addressing health disparities requires alignment, commitment, focus, and accountability.
To this end, we created the Health Demographic Profile (HDP) in our myCalPERS member self-service portal, that allows health members to self-report their race, ethnicity, preferred language, sexual orientation, and gender identity. We’re using their responses to see if health outcomes, medical treatment, or preventive care are different based on a member’s demographics. The information from the HDP will be used to direct programs, policies, and interventions on behalf of our members.
- Established the Health Equity Team, an internal CalPERS workgroup comprised of team members from the Clinical Policy and Programs Section (CPPS), the Health Account Management Division (HAMD), PAOF, and the Strategic Health Operations Division.
- Initiated the framework for HDP, which is a secure and confidential way for members to voluntarily share their race, ethnicity, preferred language, sexual orientation, and gender identity.
- The CPPS team and the Grievance and Appeals team partnered to begin collecting HDP data for grievance and appeals cases. The goal of this partnership is to begin identifying trends and areas of health care access or quality of care disparities in 2022.
- February campaign launched to help educate and promote HDP.
- The Health Equity Team convened consumer advocacy groups to learn best practices and gain insight to create CalPERS’ HDP.
- As of June 30, a total of 24,846 profiles were created, moving CalPERS almost one-quarter of the way to our threshold goal of 100,000 profiles.
- The CPPS team partnered with UC Davis researchers to build a framework to evaluate access to behavioral health through surveying CalPERS members. The project began with the compilation of current research, review of current benefits, and evaluation of the annual Member Health Survey. The Behavioral Health Access Survey, which launched in late 2021, will collect health demographic data to identify any existing disparities in behavioral health care among CalPERS members.
- Upon reaching 100,000 completed profiles through myCalPERS HDP, CalPERS will begin evaluating clinical quality measures for colorectal cancer screening, breast cancer screening, and comprehensive diabetes care HbA1c control.
- Several changes were adopted in 2021-2022 related to health plan contract implementation. These changes included the following:
- Addition of standards to address health care gaps created by the COVID-19 pandemic; inclusion of childhood immunization status; and addition of colorectal cancer screening
- Requirement that health plans work to attain the National Committee for Quality Assurance Multicultural Health Care Distinction for 2022, and report on cultural needs of members and culturally appropriate access to care
- Require health plans to collect and report self-reported members by race/ethnicity information
- The CPPS team conducted an analysis by reviewing current benefits and recent grievance and appeals data to better understand limitations of current CalPERS benefits and to identify disparities in care quality or access to create a more equitable benefit structure. The review identified areas for improvement related to reproductive health and infertility benefits. While CalPERS benefits provide some services related to reproductive health, the current benefit language may exclude certain LGBTQ+ members or cause delays in care.
- The research led to recommendations to change benefits and benefit language.
- The reproductive health equity benefit change will improve quality of care and timely access to time-sensitive services, such as cervical and breast cancer screening, sexually transmitted infection screening and treatment, and pregnancy services, including abortion care. The change ensures that all members will have access to timely, equitable, and competent care without undue barriers or delays, regardless of sex assigned at birth, sexual orientation, or gender identity
- The infertility language change will update the definition of infertility to provide treatment access to members regardless of age, gender identity, sexual orientation, or marital status. Adoption of the new infertility definition will create a more equitable benefit structure for all members, regardless of their sexual orientation, gender identity, or relationship status
- Preferred Provider Organization Health Plans will implement matching their members to a primary care provider. Research shows that access to a PCP is associated with positive health outcomes through the relationships they establish with their patients and investment in their patients’ wellbeing. PCPs catch illnesses before they become severe and help address health disparities their patients may encounter
- The CPPS team partnered with other large health care purchasers, including Covered California, the Department of Managed Health Care, the Department of Health Care Services, and our health plans to create the Joint Purchasers Clinical Forum workgroup to discuss health equity and alignment with large purchasers to increase access, address inequities, and improve quality of health care at an affordable cost. The work conducted by this group has the potential for not only impacting CalPERS health plan members, but all Californians.