roll out and another 1.4 million enrolled in cover california and estimate the uninsured rate drops by 50 percent in san francisco we had similar success we had had about 46 thousand people enrolled in medi-cal expanded coverage the total caseload which does the enrollment has almost doubled over the past year and another 41 enrolled in medi-cal and we saw the healthy enrollment drop by 60 percent ems covered california recently closed up u up it's second enrolled in the middle of february i kind of wanted to do a comparison between last year's open enrollment and this year's open

enrollment those are only the new people in 2014 we had 41,000 people in 2015 another 11 thousand plus enrolled in san francisco when we had a comparison of which tier plan they picked in blue we've got 2014 and orange 2015 so you can see the overhead profile didn't change they're still the most important, however, the most popular is the browns plan. >> so this map shows plan selection by carries and so again in blue in 2014 we see the chinese health plan was the most

popular. >> evenly in the health net in 2015 kaiser was by far the most important plan by the new legal enrolled people so the other part of covered california story is the renewal to stating i mentioned early 1.4 million people enrolled in 2014 one point plus million were eligible done by covered california among the 4 point plus mill were eligible for medi-cal and others were forward to the process to covered california let's people know they can stay with their current plan or choice another plan among the 32 percent some logged

on to covered california to see if they might prefer another plan whether or not they've challenged we do have the data 61 percent never respond they were passively enrolled into their current plan the majority of the people reenrolling or passively rereportedly on 6 percent choose a different carry in 2014 so unfortunately, we don't have county level data we've hoping through california we'll have more information as it goes on but if we apply the statewide it is a 72 percent renewal rate of the 41 thousand people that

enrolled last year would have reenrolled by san francisco out paced the state of people enrolling i think we have more people more willing than statewide moving on 0 medi-cal that is restricted to the 2014 calendar year so you may recall we shared our projects 2014 last year and 81 to 95 thousand people statewide had been eligible for medal we expected half of them to enroll and actually from the hums agency reports that our projectors were exceeded actually enrollment preceded we have 56 thousand people enrolled in medi-cal and other thousands enrolled in

non-magazine i did refers to people that are peripheral eligible for medi-cal but not enrolled and includes people renewing from a previous year s t h organization caseload nearly doubled this is a graphic representation in the middle line you see in the orange we've got they started off their enrollment at one hundred thousand people in san francisco and by the end of the year in the top in the blue you see the total is one hundred and 88 thesis so the majority of that is coming from the enrollment of 26 thousand with an increase of 32 in non-magazine i and as you can see there were more magazine i enrolled moving forward we're hoping to have data on insurance

runld. >> how many of the medi-cal population stated with medal or had changes in covered california or went elsewhere this data is hopefully coming i also mentioned we have a adrenalin in healthy san francisco this is a graphic representation from showing monthly enrollment through march 2014 as you can see the two gray areas represent the two open enrollment periods in the nca we thought a faster enrollment during the first engrossment enrollment and again in the middle of the year the program we found a lot of people enrolled in medi-cal but as in healthy san francisco and so right now at the end of the march we have 16 thousand people in healthy san francisco and we

do anticipate that more people will be leaving as you recall we had the transition period in place so as a at some point of who healthy san francisco is right now by in case it is still heavily started towards the low income and its middle and the people above poverty it is among those people we expect to leave they'll no longer be able to stay in healthy san francisco because they'll be eligible for covered california and covered california as extend a special enrollment period through april 30th for people not expecting tax penalty for not having insurance hopefully, they'll release the data on that

and eligibility enrollment is available year-round and small businesses can purchase through the small business program and covered california as focused the two years an individual enrollment they recently launched a rebranding effort for for businesses to participate and individuals that have qualified including a change in our family status and moving into other areas or having income subsidies or becoming eligibility for corporate coverage those are all grounds for special enrollment that's all i have i'll be happy to answer any questions. >> commissioners committees from the presentation. >> yeah. a comment the projects far exceeded that this is a testament to the far outreach

work. >> that's a big testament to our healthy san francisco we tricked almost 14 thousand people and knew a lot of people that were eligible. >> we were worried about the people that wouldn't reopt it looks like it is trend that way. >> hopefully the state data applies it is laboratory more concerting for the medi-cal population you want to make sure they renew that data will be interesting. >> it will be important to follow up on. >> thank you commissioner chung. >> thank you for this presentation i think that with our san francisco health network patient how many actually stated in the network after they you know received extension or

enrolled in their own plan a or triggered. >> i'll have to leave it up to the network i'll say that in this slide here if you look at this member gallo an enrollment there is a two to three months there a from the time they pick their plan. >> thank you. >> i think the fact that the interesting dynamics it is you know it is great that we have more patients population and power to make choices for themselves and you know some of them those choices might be like choosing agree different plan and not staying with f ph and we have an experiment called healthy san francisco it is valid for those who don't

qualify for sf ata the general public really recognizes the limitation of healthy san francisco and the requirement of the individual mandate we don't like going down people got off healthy san francisco and got on permanent insurance that is important the department supports the sf plans. >> first of all, the gross reduction in our state is just amazing that san francisco beat the states expectation is more amazing i just can't start this conversation enough is enough congratulations and praise that was the whole purpose to move

people with no insurance to have insurance and then worried about the services they get with those insurance company but with insurance we're so much better off i want to thank the department working closely with the state and the whole community it is not only 9 public but the private and pun coarse and everyone enrolling i have 3 remaining questions i'm not seeing the data how many remaining uninsured do we have in san francisco i think we start out with 35 or 40 thousand down to 15 it is a small population so that's the first question the second would be i can ask one at a point.

>> so at the end of the 201387 thousand. >> 87 in california. >> in san francisco and the majority were actually in healthy san francisco so in september we have 52 though in healthy san francisco urging some enrollment projections we had from cal son the california insurance models run by uc berkley that's what the state used to stage enforcement into medal and it's covered california so we estimated that after the first year of ac a implementation 42 to 50 thousand people remaining urban insured that might be a little bit on the high-end at this point we have so much success in people enrolling but again, we're

having data limitations that - those projections were done using census data not available for september of this year 2014. >> i see the 16 thousand number in healthy san francisco we have 42 thousand and 15 thousand. >> so the 42 thousand yourself referring to - the enrollment in covered california. >> in the one with the darned graft in healthy san francisco. >> we don't necessarily know where those people end up so we know that a lot of them left and were eligible for medi-cal but no way of running san francisco data up against covered california to see how many end up there some of them could have gotten job based coverage so the

other promotions in the enrollment is citywide enrollment and, of course people not in healthy san francisco that were urban insured. >> so our san franciscans about 40 thousand insured; right? >> right. >> that's a little bit larger and naefrmd to healthy san francisco do we know what percentage disenrolled but there was there a lot of change within our enrollment of people leaving our health network sorry. >> i guess this depends on where we end up if they respect to covered california they would have had the option to stay if medi-cal my understanding is that health san francisco participant were happy so they

had the option to stay and the question is to the county data you don't have yet so the third yee question i guess we're seeing this large reduction in san francisco population what's the healthy san francisco i know we made a decision i'm asking you know we renewed it. >> yes. we're still looking at the issue of affordability i know that colorado lien is working on that will come to the commission prior to august for us for review and decision on that. >> thank you very much thank you. >> any other comments and so we'll note that we're expect to have information concerning healthy san francisco and probable at this time good to the state data will gotten down

to the county level. >> hopefully. >> and seeing what actually happened in nca enrollment and reenrollment and not just for jan that will help inform healthy san francisco discussion then. >> any further questions if not thank you very much for the fine presentation we'll move on to the next item. >> item 89 the san francisco health network 6 month update.

>> one second commissioners. >> good afternoon, commissioners rosen with the san francisco health network so today, we will be providing updates and highlight in 4 key areas of operations i'll start by sharing information on the office of managed care which will hostile some of the

information on the patient population served and enrollment information in the managed care products next i'll go into the current efforts regarding 345r9 and branding where we hope to go in the future in that area and then i will i'm going to turn it over to our new chief medical officer alice chin to share a review of our way forward metrics with the most updated area and she'll go over metrics and measures we'll be present to you for the first time across the network so in this slide we highlighting san francisco health network by division goal of this slide so give you a sense of how many patient we

touch across the entire network so roughly you'll see that we've touched over one hundred and 20 thousand lives throughout the network recidivism one in eight people in san francisco received service from some part of our network that as you can see by the bar graph that volume various by the divisions given the broad breath and differentiates between the san francisco by the different division for example, on the one hand to the far left is laguna which provided services to a little over 12 hundred patient recognizing they provide twenty-four hour care rather than the san francisco general hospital over one hundred thousand varies for someone that

stays in the unit for that a 6 month stays and also some place that came in to the lab for a blood draw so i'm sharing this slide to give you an overview of our managed care office in terms of the managed care product lines they oversee their shown not by chart to the right our medi-cal managed care population healthy workers the healthy san francisco program and healthy kids basic take away from this slide is we compare the graft of the bar chart in september 2014 to december 2014 you see that we saw an increase of 4 percent in our total managed care lives playground to our office of

managed care. >> in terms of we've made great strives with the newly managed office of care i want to share highlights in terms of partnerships and contractually relations my colleague talked about the 0 program in san francisco we lowered the income level from 4 hundred to 5 hundred level beginning next year to match the poverty level in terms of the partnership we've signed a contract to be the hospital and speciality care provider for their medi-cal managed products and working in conjunction with the general we're jointly securing the

strategy consultation to work together as a physician group and hospital in terms of the future plans for managed care so on this slide you see actual examples of some of the market and branding collateral materials we're currently urging i see a copy of the bridge our internal 92 newsletter that highlights the various parts of health network and to the far right lower corner our style guide we presented to you a few months ago govern our logo colors again trying to bring in more coordination and consistency across our network as we move 0 into the world of

marketing and advertising a new frontier for us this is a copy of our website we've taken the approach of focusing both on internal and external communication when it comes to marketing and branding this website is an example of what we're using for our external marketing we've also using our existing staff are in the process of developing a marketing brochure we'll use to help in our recruitment of patient and that brochure is currently being reviewed by the patient advisory committee to help to make sure we have a patient centered prospective as we go out into the marketplace our

overall approach to market is two-fold first focusing on a more homegrown approach in terms of the resources we currently have available we're building 0 on our public health system working with the existing contracts and networks and partners so for example, we're working with northeast medical services we signed a contract to learn in terms of they're marketing program and how we can use some of their techniques to assist in our own marketing effort we're seeking outdoor expertise and consultation we need to do more classic forms ever marketing some in depth marketing analysis identifying our core constituents are what motivates them to choose a provider of

care and what we can do to possess those trinity so they'll stay with us i'm sure you're aware of san francisco general hospital received a gift recently has a component of it a designated component for marketing and embarrassment of san francisco general hospital and we anticipate being able to partner with a group and side or so how 0 leverage some of the network wide branding and marketing activity so, now i am sorry the podium to mr. chin that will share and metric both operational and clinical and financial. >> good afternoon,

commissioners and director it's my pleasure to present to you an update on the metric as well an overview of the quality metric as you may remember we have 10 metrics that are widely carding represents the key challenges first, we provide timely access to services and secondly insuring final stirred up in the context of groups and third recognizing that our practical or patients have more choice we're attractive to staff and patient so as a reminder those metrics came from the h m a consultants and as the network has matured it is that respect those are not perfect metrics at the same time as we start discussing which metric better

represent what we want to achieve so with that caveat this is the decord slide you've gotten a lot of information the first thing is there a green star if so we met our target the arrows tell you is that if it is green either up and down there was a favorable change between the last two measurement points and if it's red there was an unfavorable changed a red arrow but still a green star yeah. given giggle a lot of information i'm to give you a quick overview of the metric with the understanding if you have questions we'll go into those afterward i'll start off by highlight in 5 areas we've

met our behavorial health or finance department and i'll review each of those when we look at measures one and two those represent our investment in primary care as a verizon delivery system the last quarter showed a dip in both measurement we were on track to moving upwards this quarter metric 3 represents institutional patient flow so this is some measures for laguna san francisco general hospital and laguna met it's metric for the last 4 quarters and san francisco general hospital was a great trajectory until the last quarter that is staffing and it is being addressed, care transition is a bigger conversations having to do with

affordable housing being squeezed out of the hotel beds not having places to throw people metric number had the finance measure and we met our target in terms of the expenses and number 5 is our workforce experience we implemented our first ever network wide will take 4 to 6 weeks that will serve our baseline and number 6 is civil service retirement there was several a process over purchase it is imagining efficient we know that we're looking at it very concretely and specifically at san francisco board of appeals and anticipate that the learning we have there and the process improvement will be