Message from Amy Shin
Chief Executive Officer
As we start a new decade and my tenure at HPSJ comes to a close, this  is the perfect opportunity to look back over the health care landscape and see how far we have come over the past few years. I hope you, too, will find this snapshot illustrates some of why we have growing confidence in the emerging trend we and our partners are generating for measurably improved health for this region and all we serve.
Our local economy is getting better.
One of my aspirations since coming to HPSJ seven years ago has been to see our members fully utilize our services towards gaining the solid footing they need to transition to employer-sponsored health care coverage. We now are beginning to see that happen.

As we continue to strive for a vibrant local economy, the upward regional trends in earnings and employment are encouraging. By the end of the decade, we had made great strides in closing gaps with the rest of the state. The unemployment rates were still higher than California’s statewide 3.9% rate, with 5.3% in San Joaquin County and 5.2% for Stanislaus County, but the trend is in the right direction. With more able to work, 2019 median household incomes also grew for San Joaquin and Stanislaus counties ($61,145 and $57,387, respectively), to levels closer to California’s $71,228 2019 median income. Again, a trend in the right direction.

With these positive trends, HPSJ now serves about 335,000 members. We celebrate this encouraging trend.  
 
More new members choose HPSJ.
For those in our community still needing the support of Medi-Cal during life transitions, given a choice between our local-rooted HPSJ (the major nonprofit managed care, public health plan) and the other health plan option, throughout 2019 new Medi-Cal beneficiaries overwhelmingly chose HPSJ. The numbers tell the story of our community’s trust in us:
  • 92.5% of new San Joaquin County beneficiaries chose Health Plan of San Joaquin; HPSJ had over 91% of the county’s total Medi-Cal market share in 2019
  • 82.7% of new Stanislaus County beneficiaries also chose HPSJ; HPSJ had over 67% of the county’s total Medi-Cal market share in 2019
Prospecting – and finding – silver-linings in HPSJ’s nonprofit, local health plan landscape.
That so many new members are choosing HPSJ is gratifying. But being local, with deep roots maintained throughout our community, tells only part of the story.
 
When facing the real-world, daily pressures for our wonderfully diverse, medically vulnerable community, we have never had sufficient revenue and talent. That is why we have focused on innovation, hired and trained a first-rate HPSJ workforce willing to think creatively and hold themselves accountable, and sought out myriad local collaborations to leverage those resources and talents we do have.  
 
We are proud to share with you our latest Community Report. Below we feature how our decade of investment is paying off. Then we share our sanguine strategies in 2019 to deliver for our members and community: women’s health, healthcare provider collaborations, and local healthcare workforce development.  
 
Throughout the past decade, and into the next, we invest for now, with an eye to the long-term. Here are a few of our building block investments.

Welcoming Stanislaus County into the HPSJ community of health care – In 2011, HPSJ won the bid to bring the local health plan to the Stanislaus community as the Stanislaus Medi-Cal Managed Care Plan and started operating in the county in 2013. With an expanded service territory, we acted on the opportunity to offer our members services and benefits most convenient to them across the two counties, regardless of where they live and work or go to school. We integrated ourselves into the community, as we had done for San Joaquin County, so that we truly understand the needs of Stanislaus residents.

National Accreditation – HPSJ first achieved NCQA accreditation in 2015 and we are now in the three-year reaccreditation earned in 2018. NCQA is the rigorous, nonprofit National Committee for Quality Assurance. This set of achievements was made possible by a strong dedicated staff, committed provider partners, and a laser-like focus on raising the quality levels for the services and benefits we provide our members and by extension our community.

Innovation – We continue to fill gaps for needed services, along with our committed partners, such as with the palliative care program, programs to address opioid misuse/addiction, post-hospitalization recuperative care, the kids’ oral health initiative, and women’s health. We are proud of addressing health disparities through our women’s health initiative, the “I Choose Me!” campaign.

Providing more great jobs in San Joaquin and Stanislaus counties – In early 2013, we had 220 employees. As of 2019, we had 400 positions, ensuring that we provide local opportunities for career advancement for professionals in a wide range of health care and business-related fields. Towards continuing to build a strong workforce, we launched HPSJ University through which our employees can learn, grow, and advance in their careers, taking advantage of thousands of courses, available online.

Strong, Real-time Provider Network Support – Our members’ access to quality health care leads directly through our Provider Network, where we have worked hard to offer practical supports ranging from an expanding provider incentives program, claims processing that is among the most efficient in California, and technology tools like member-specific care reports via the secure provider portal that inform our providers to deliver timely preventive care and monitoring of chronic diseases.

Employee Volunteerism for our Community – Our dedicated, hardworking staff members continue to find so many ways to give their personal time to local causes. With HPSJ Walks for Health, many come out on weekends to support local health causes and organizations, including the Alzheimer’s Association, Multiple Sclerosis, American Cancer Society, and the March of Dimes, for which HPSJ pays walk sponsorship fees. Literacy and health literacy events generate enthusiastic participation for events like Rotary Read-Ins at elementary schools, Little Free Libraries, and organizing an entire subdivision of community organizations for the literacy-anchored annual Family Day at the Park. Management staff make time to serve on community boards and advisory committees, including United Way, Health Careers Academy High School, Community Health Leadership Council, Women in Healthcare Information Technology, and the Burn Foundation.
 
Women's Health - The "I Choose Me!" Campaign
Alarmingly low breast cancer screenings prompted us to try something different. The 2019 campaign is already yielding results in targeted zip codes - a 5% increase, and now growing.
 
"For my team and me, it was a real wake-up call to see how our members, in whole neighborhoods, were not using this potentially life-saving screening service – part of their free Medi-Cal benefit. We thought we had built a path to this amazing service; Why weren’t they coming?”   

Andrea Swan, HPSJ Manager, Quality Management Operations, seen at right with members of the HPSJ professionals teaming with members, providers, and local community groups.   

 In 2019, we reached out to our members and we:
  • Connected with block parties where our members live
  • Crafted culturally- and gender-sensitive materials that women told us delivered facts and figures in ways most appealing and useful to them – and we also posted these, as many find online communications convenient
  • Helped women book appointments with nearby imaging centers in the HPSJ provider network, at times most convenient for our member
  • Reached out with phone calls to each member, to assess any issues with completing their mammograms and to offer assistance and/or support, if needed
The Results: More members understand the importance of breast cancer screening for their best health, and how HPSJ can assist them with services and benefits that are part of their health plan. More providers have a better understanding of how to work with patients and work around their barriers to care. By the end of Calendar Year 2019, saw a more than 5% increase in breast cancer screening.
 
Real Life Stories
At one of our “I Choose Me!” neighborhood block parties for breast cancer screening, we heard from HPSJ member Brandy Anderson, a breast cancer survivor.

 “When you think of cancer you think of older people, and ‘Oh, it’s never going to happen to me.’ But I fell into the 1% of individuals that developed breast cancer under the age of 40. I was 31 when I got diagnosed and all I could think about was my 3 and 5 year old kids and that I wanted to be there to see them grow old."
Provider Collaborations –
More Concrete Moves Forward for our Members and Community

Through ongoing, innovative supports for our provider network, in 2019 members benefited from timely, consistent use of their health benefits for more preventative care, plus more effective attention for chronic conditions such as the diabetes and asthma endemic to our Central Valley communities.
 
Whole Person Care
HPSJ joined the Whole Person Care (WPC) pilot project, led locally by the San Joaquin County Health Care Services Agency, and in 2019 we helped identify HPSJ members who were assessed to be at high risk of homelessness with chronic disease(s). Each of these WPC enrollees received multifaceted care that ranged from leveraged Care Management, to disease- and condition-specific local community supports, to behavioral health and timely, consistent medical support for recuperative and respite care. Over the course of this multi-year pilot, close to 2000 residents were served.
 
Transitions of Care
Transitioning from inpatient care is often fraught with challenges and barriers to daily support. In 2019 we began to see progress in reducing hospital readmissions. This was the result of intense work with individual members including attention to their special needs and setting them up for success once discharged from an acute care facility. We quickly assessed and met each of their requirements for durable medical equipment, as well as scheduling follow up appointments, referrals for social worker appointments, or Chronic Case Management. One key step was to strengthen our relationships with safety net Federally Qualified Heath Centers (FQHCs) and their discharge staff. At the end of the day, staff and HPSJ are facing the same challenges with our member population. But working together has made it easier for all involved, most importantly for our members.
 
Proposition 56 Provider Incentives
In addition to the expanded HPSJ provider incentive payments program, we also administered the state’s Proposition 56 Supplemental Payments. We took this opportunity to work even more collaboratively with our providers to maximize their revenue and the care our members receive. HPSJ encouraged regular office visits by members where preventative care such as timely immunizations and tests, and behavioral health assessments and care, could be delivered, along with family planning, psychiatric diagnosis, and pharmacologic management. With these incentives, our providers were better able to support their HPSJ patients and they added to their regular HPSJ payments which they could use to reinvest into their practices. 
Developing the Local Healthcare Workforce in our Community

HealthForce Partners
Health professionals do not happen overnight. With that long view, HPSJ helped found, and continues to fund HealthForce Partners, an industry-led healthcare, education, and workforce development collaboration working to meet the needs of the local healthcare industry and the employment needs of community residents. With an initial focus of San Joaquin, Stanislaus, and Merced counties, they are set to be a vital addition to the Central Valley health landscape.  HPSJ Executive Team members continue hands-on involvement, including the Chief Executive Officer who serves on the HealthForce Partners board, and the Chief People Officer who serves on a key committee that connects senior Human Resources leaders.
 
HPSJ Health Careers Scholarship Program –
Since 2009, Health Plan of San Joaquin has awarded educational scholarships to nearly 200 local students to advance their health care careers and become our future nurses, physicians, pharmacists, medical assistants, and more. In 2019, we were able to increase each scholarship to $3,000 per student. Each also was matched with their own mentor, drawn from the ranks of enthusiastic HPSJ professionals volunteering their time, their ears, and their wise support.
Medi-Cal covers over 518,000 residents in San Joaquin and Stanislaus Counties.


About 40% of San Joaquin & Stanislaus County residents have Medi-Cal coverage.
Throughout 2019, Health Plan of San Joaquin membership was about 335,000.

Our Membership by Population


Our Providers, Our Partners


HPSJ has a long history of serving our members in partnership with safety-net and traditional Medi-Cal providers.

$1 Billion


In 2019, HPSJ received annual revenue from the state and federal governments totaling $1 Billion. We distributed $940 Million of that revenue to our community healthcare providers, to cover members' healthcare costs.
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