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IHA California Regional Healthcare Cost & Quality Atlas Update Finds Better Quality, Lower Costs When Providers and Health Plans Share Financial Risk

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The Integrated Healthcare Association released the most recent results of its California Regional Healthcare Cost & Quality Atlas, a key statewide source for comparative healthcare performance information. The Atlas uses over two dozen metrics, such as preventive screenings, care for chronic conditions, emergency department visits, and member cost-sharing, to examine performance across a wide range of clinical quality, hospital utilization, insurance type, and cost of care topics.

Health plans, providers, purchasers, policymakers, and consumers can use the Atlas to compare quality and cost of care provided to Californians. The 2020 Atlas results cover nearly 16 million Californians. This includes 14.1 million commercial lives and nearly 2 million Medicare Advantage lives – around 70% of each of these populations. Comparison of year-over-year results are available, as well as results across insurance type, regions, and provider risk-sharing categories.

Consistent with prior years, the results released for 2020 show that better care and lower costs typically result when plans and providers share in the financial risk through a capitation arrangement compared to fee-for-service models. This analysis is based on data from 11 health plans, representing 7.9 million commercial lives cared for under health maintenance organization (HMO), preferred provider organization (PPO), and exclusive provider organization (EPO) products, both fully insured and self-insured.

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