Dear Providers,

I am writing this the day after healthcare reform passed; it is a day to celebrate.  It will be a challenging four years between now and full implementation, but for the first time our country has made healthcare coverage a right, not a privilege.

Our country has mandated access to coverage; now our state is mandating timely access.  As of January 2011, the state is holding San Francisco Health Plan accountable for ensuring that our members receive primary care within 10 days of the request, along with many other requirements.  We realize that this is easier to mandate than to achieve.  We therefore are piloting a ”mini-collaborative” program with 5 clinics, in the effort to provide support and technical assistance to improve timely access.  We will be working closely with providers and medical groups over the next year.

There has been tremendous controversy about healthcare screening.  Providers have expressed concern about what San Francisco Health Plan will continue to cover.  Since we consider the decision to screen for breast, cervical or prostate cancer as a decision between provider and patient, we encourage providers to follow evidence-based guidelines but will not be restricting mammogram access based on age.  We recently reviewed screening guidelines with our Physician Advisory Committee; please click here to view them.

One last update:  although this newsletter is aimed at providers who see our insured members, we did want to call out the success of Strength in Numbers, a “pay for improvement” initiative through Healthy San Francisco.  In just 11 months of incentives and technical assistance in 24 medical homes, we saw 29% improvement in A1c testing and a 30% improvement in LDL testing overall, and have heard tremendous support from providers for the program.

Yours in health,

Kelly Pfeifer, MD