Integrating an Opioid Treatment Program with Primary Care

Project Goal: To increase care coordination and the number of doors for a patient with substance use disorder to access "whole person care" by creating and integrated system of care between and opioid treatment program and primary care setting. Increased access will improve utilization and treatment and decrease death and disability from opioid use disorder.

Improving Linkage to Care at HIV Diagnosis

Project Goal: To improve linkage-to-care for persons newly diagnosed with human immunodeficiency virus in Alameda County as part of a treatment-as-prevention strategy.

Improving Adolescent Knowledge and Utilization of Reproductive Health Services Using a Youth-Driven “Literacy” Project

Project Goal: To improve knowledge and utilization of reproductive health services in our health center through education of adolescents in our service area using an intervention developed by youth.

Redefining Usual Care in the Gynecology Clinic: A Collaborative Care Depression Intervention Model

Project Goal: To improve outcomes of women with depression who obtain care in the Gynecology Clinic through an integrated Collaborative Care model that will immediately engage the patient in her depression care, promote patient input into care treatment options, track care, and step care to reach the desired target state.

Achieving Alignment: Integrating Complex Care Programs Under a Population Management Strategy

Project Goal: To improve the quality of care for medically & socially complex patients receiving primary care through Alameda Health System by deploying a standardized model of complex care management as part of a cogent population management strategy.

Midwives in the Mainstream: From Practice Sustainability to Transforming Maternity Care in California

Project Goals: To develop a replicable sustainable midwifery business case and increase number of private insurance clients delivering at Marin General Hospital.

A Model for Home Based Palliative Care

Project Goal: To increase access to ambulatory palliative care by establishing a financially sustainable service line within MemorialCare’s hospice program.

The Galileo Project: The Global Risk Playbook for Transformative Population Health

Project Goal: To build, validate, and implement a replicable high-risk/utilizer care management program focused on upstream health risk reduction – for payors and providers approaching global financial risk.

A Model for Integrating Behavioral Health Services into LA County’s Public Safety Net Primary Care Clinics

Project Goal: To increase Los Angeles County primary care patients’ access to broad range behavioral health (BH) services by integrating BH providers into primary care medical homes.

Scaling Existing and Designing New Population Health Management Strategies for Success in a New Alternative Payment Model

Project Goal: UCSF health will decrease the total cost of care for attributed medicare beneficiaries by scaling outpatient care management services and care at home programs, adding new skilled nursing facility transitions and End Stage Renal Disease programs, and leverage new Center for Medicare and Medicaid Services claims data.