posted by Alicia Caramenico
on February 24, 2017
Meet L.A. Care Health Plan. Serving more than 2 million members in Los Angeles, it’s the nation’s largest publicly operated health plan. John Baackes is CEO, and one of AHIP’s new board members. He recently spoke with us about how his organization is helping Los Angelenos live healthier lives.
You bring more than 30 years of health care experience to your role as L.A. Care Health Plan CEO. How has your background influenced your work at L.A. Care?
Baackes: I have had the privilege of holding a number of different roles, which have provided me with a broad lens to understand the dynamic and complex landscape of health care. When I was hired to run L.A. Care, the organization had six product lines, but was operating like a one-product company. One of the immediate changes I began to implement was to transition the organization from a functional to a matrix structure. This was a rather urgent priority given the company had grown tremendously – in terms of members and employees – in such a short period of time as a result of the Affordable Care Act. The goal was to create product line accountability and optimize operations. It remains a work in progress, but I am proud to say we have already accomplished several milestones, including launching our first direct network of providers.
How did you make the decision to become involved as a member of the AHIP Board?
Baackes: The decision to become an AHIP board member was easy. Having a seat at the table means I can serve as the voice for our two million members – and frankly, this is now more important than ever. Our members are among the most vulnerable people in Los Angeles County. It is my priority to ensure access to care for all L.A. Care members be preserved regardless of the future of the Affordable Care Act.
What is your ideal vision of health care in the future?
Baackes: The future of health care will largely be shaped by its capacity to be sustainable and accountable. Successful models of care delivery, particularly government-subsidized health care, require a consistent and reliable method of funding. When payers and providers are not preoccupied with finances, they can truly focus and innovate on ways to keep vulnerable populations healthy. Equally important will be valuing good health outcomes. The good news is that we are already laying the foundation for that.
What are some new initiatives or projects you’re leading at L.A. Care?
Baackes: Historically, L.A. Care has worked with Independent Practice Associations (IPAs) to manage the care of our members. While this has mostly worked, it is not without challenges. When I arrived at L.A. Care in 2015, I made an assessment and identified opportunities where the organization could benefit from contracting directly with physicians and specialists in certain geographic regions. Last year we launched the L.A. Care Community Access Network (CAN) in the Antelope Valley region of Los Angeles County. This direct network is designed to enhance the health care access currently afforded by our IPAs. By increasing the number of contracted local physicians and specialists in the Antelope Valley, we are aiming to improve the experience of our members and their health outcomes. Additionally, the network brings added value to providers who are able to directly contract with us, including streamlined patient care communication, expedited authorization of claims and payments, and dedicated training resources.
How does active community engagement help L.A. Care better serve its members?
Baackes: L.A. Care is uniquely positioned to engage with our members to better serve them. We have 15 consumer councils that influence decision-making at the Board level. It is a direct pipeline from our consumers to the Board. For example, we recently received feedback involving the needs of members who use wheelchairs. Patients in wheelchairs need specialized equipment to be examined and weighed. In many cases that is not available in a typical medical provider setting. As a result of this feedback, we are now working on potential solutions to better meet the needs of those patients, and how we assign members to providers.
Anything else you would like to share about yourself or your organization?
Baackes: One of the ways we help our members and the community adopt healthy lifestyles is through our four Family Resource Centers, which serve up to 4,000 people per month. Each center offers a full schedule of classes which range from yoga to Zumba to stress management. The centers also have nutrition workshops that teach everything about healthy foods and recipes to improve well-being and help manage chronic conditions like diabetes. Visitors may speak with a dietician or see a social worker by appointment. Everything offered is free. L.A. Care is slated to open as many as three new centers in 2017.
This interview has been condensed and edited for clarity.