Building Initiatives at Health Plan of San Mateo with HPSM Team

The Health Plan of San Mateo (HPSM) has a five-year, $60 million Primary Care Investment Strategy that aims to better allocate resources, improve population health, support their workforce, and enhance the care experience. Find out how they are working with their provider network to implement this innovative model. https://lnkd.in/e3RZXD67 CC: Miriam Sheinbein, MD, IBCLC, Chris Esguerra, Colleen Murphey, Luarnie Bermudo Barber, MPH, MS, Mat Thomas, Primary Care Collaborative

This is an important demonstration of what it looks like when a health plan puts primary care and value based payment models at the center of its strategy. Sustained investment and alignment like this can drive better health outcomes, improve affordability, and reduce total cost, and should serve as a blueprint for policymakers and other health plans.

This is a great plan, except for value based. Why use the catchy, disturbing volume to value mantra? The designers that promote this have been the ones taking out trust in primary care as a career. They have moved our nation from the most experienced to the least experienced primary care in our history over the last 40 years. The designers have not valued our personal and professional lives and at every turn they have shaped more to do of higher complexity involving greater stress while distracting us from what called us to primary care in the first place. Full understanding of access comes with the realization that lack of access in a population or plan or a nation is about lack of volume. Volume and access are linked in ways few understand without decades of volume experience. We need increased volume because we have substantial populations with no or low access. Volume added to such a population is likely the only major boost in cost savings, access, and quality improvement that can arise from primary care. Incremental changes are not going to shape much change in access, cost, and quality We need team members with volume, continuity, and experience - denied by the micromanagement/value based designs. It is pretty obvious that few enter primary care to harvest millions. Volume is a term misused and repeated to shape emotions and disturbance - to drive the micromanagement agenda. Just say NO. It is pretty obvious that the micromanagement bandwagon has gone way too far and is finishing off what remains of trust in primary care. The fact that you focus your PLAN on capacity, bandwidth, integration, coordination, and joy indicates advanced understanding. Replace value based with the word "transformation" If you - transform finances and invest to - transform to most and best team members, thus - transforming the practice environments, you will - transform the only innovation that matters - one on one with each patient. This is the ChenMed way and the Southcentral NUKA design that adds the cultural focus. These are transformation designs, not value based. They work fabulously well because the take populations with no or low access to superior access. Value based is about cost cutting. It has to be because outcomes are so fixed in place that changing the equation requires lower costs. The denominator is fixed in place so the numerator must be reduced - by cost cutting which is the primary vehicle that harms most Americans most behind What you are doing in your plan is transformation - to trust in primary care as a career - to continuity and experience in team members - to most and best team members This is about maximal retention in - the same specialty - same practice with the same team members - same community and - learning maximized on the same patients. This shapes the only innovation that matters - one on one with each patient. Who cares about the numbers when it is relationships, support, and caring that matter?

Good overview of Association for Community Affiliated Plans (ACAP) member Health Plan of San Mateo (HPSM)’s work on primary care.

So excited to see HPSM's work on primary care investment getting some attention! This is a perfect example of how increasing primary care spend is not as simple as just increasing reimbursement to primary care. Yes, reimbursement often needs to go up. But that, by itself, is often insufficient to address the needs and pain points of primary care providers in a region. A region-specific strategy really helps think through exactly what is needed and how to make primary care investment as effective as possible. As DHCS works toward an All Plan Letter requiring Medi-Cal managed care plans to hit targets for primary care spending, this report (along with a forthcoming report from CHCF on a primary care spend convening in Nov 2025) will serve as reference points for tactics to effectively increase primary care spending. Carlina Hansen, Jill Yegian, Melanie Ridley, Diana Camacho, Jennifer Sayles, Tammy Fisher

I walked away from the National Cooperative of Health Networks annual conference genuinely grateful for the depth of conversation, candor, and connection across this community. What stood out most wasn’t just the content, but the shared commitment to jointly solving incredibly complex challenges in rural health. A few themes that stuck with me: Collaboration isn’t optional anymore. Whether through clinically integrated networks or more flexible partnerships, the message was clear: no rural hospital can operate in isolation and remain sustainable. Governance and trust matter as much as strategy. The most successful networks are grounded in local control, transparency, and strong relationships, not just structure. Data is becoming a unifier. From payer negotiations to quality improvement, shared data platforms are driving real, measurable change across regions. The policy environment is shifting quickly. There’s a real sense of urgency around how federal programs evolve, and how rural providers engage with them. And of course, a lot of discussion around the Rural Health Transformation Program (RHTP), both the opportunity and the complexity. It’s a significant level of funding flowing into states, but with tight constraints and real limitations on capital use. Success will depend heavily on how well providers engage at the state level and whether funding aligns with actual community and system needs. There’s also a clear undercurrent: what happens after the 5-year window? Sustainability beyond the program is top of mind. Overall, the takeaway is this: rural healthcare isn’t short on ideas, it’s navigating execution, alignment, and capital in a rapidly changing landscape. Appreciative of the conversations, new connections, and the opportunity to learn from so many leaders doing this work on the ground every day. Looking forward to continuing the dialogue! #ruralhealth #communityhealth #nchn #ruralhealthfinance #buildinghealthiercommunitiestogether #highpoint #healthcarerealestate

Access to high‑quality healthcare shouldn’t depend on where you live. That’s what RESOLVE: A Rural Health Collaborative is working to change—bringing together Providence and the University of Montana to build rural health solutions shaped by the communities they serve. “When innovation is built around the realities of rural communities, it’s far more powerful than adapting urban models after the fact.” says Bill Wright, chief resource officer. Watch the video to see how this partnership is helping shape the future of rural healthcare. #RuralHealth #HealthEquity #HealthcareInnovation #Partnership

This is fantastic and long overdue in the rural context. Rural health doesn’t need more pilots; it needs coherent strategy, modern infrastructure, and the ability to execute at scale. As RHTP rolls forward, the real question is how we prevent it from becoming transactional and instead use this moment to catalyze lasting technology and operating model transformation. How do we ensure RHTP drives sustainable change not just activity? #ruralhealth #innovation #partnership #RHTP

The Mississippi Rural Health Transformation Program (RHTP) is moving forward with a $205 million investment aimed at strengthening and modernizing rural health systems across the state. This funding represents a major opportunity to improve care delivery, expand access, and support long-term sustainability for providers and the communities they serve. The official Mississippi RHTP website is now live and serves as a central hub for program information, priority initiatives, and the overall framework. Members are encouraged to review the site to understand how these efforts may align with their organization’s goals. Additional details, including training opportunities and upcoming Requests for Proposals (RFPs), will be released in the coming weeks. Now is the time to begin identifying and refining potential projects that could support your community, including telehealth expansion, workforce development, facility improvements, emergency preparedness, and technology enhancements. For questions, project ideas, or technical assistance, contact Ryan Kelly at ryan.kelly@mississippirural.org. We look forward to continuing this work together to strengthen rural health across Mississippi.

Five asks of Member States at the 79th World Health Assembly. As Members States move towards a more unified process to reform global health architecture at WHA79, our Senior Director of Policy, Marionka Pohl, joins colleagues - Alhadi Khogali, Renée de Jong, Dr. Rispah Walumbe and Arush Lal, PhD - calling for universal health coverage (UHC) to anchor reform efforts in an article for Health Policy Watch. So what are the five asks they call for? 1️⃣ Anchor global health architecture reform in UHC and country ownership The WHO-led GHA reform process should align global health mandates, financing, and incentives behind country-led priorities, with clear timelines and accountability for implementation. Country-led governance must be the foundation of any reformed architecture. 2️⃣ Invest in primary health care and sustainable financing Strengthen public financial management, coordinate financing through country-led platforms, and increase domestic investment in health systems. This requires progressive financial reforms and renewed attention to the Economics of Health for All agenda. 3️⃣ Strengthen the health workforce for UHC Expand fiscal space for health workers and align donor investments with national workforce strategies and employment plans. 4️⃣ Institutionalize social participation and accountability The WHA77 social participation resolution must be operationalize, including the WHO establishing regional and national consultative bodies to enable continuous dialogue and oversight. Civil society engagement is critical to shaping policies that reflect the needs of affected populations. 5️⃣ Safeguard UHC in crisis and conflict settings Ensure global health financing mechanisms include protected funding for essential health services in fragile and crisis-affected contexts. Member States must ensure their decisions translate into practical improvements for the people most affected by systemic failure. WHA79 is a pivotal moment. It can either be remembered as the point where governments anchored reform in equity and country needs, or another missed opportunity.