Fundamental Concepts for Managing Risk and Understanding the Total Cost of Care

A California Improvement Network lexicon

April 23, 2019

Sandra Newman, LSN Health Strategy

This resource is designed to serve as a primer for anyone interested in gaining a better understanding of health payment models in California and nationally. It focuses on concepts and terminology related to value-based payment models and to health care delivery models and systems.

The publication is organized alphabetically by key concepts. Terms that are related to a key concept are defined below that concept. Words that are italicized are defined elsewhere in the publication.

The publication was prepared by the California Quality Collaborative, a managing partner of the California Improvement Network (CIN). Please share this document broadly with your networks.

What's Trending

Explore the most popular publications, blogs, resources, and more from CHCF.

The 2024 CHCF Central Valley Health Policy Survey

Jen Joynt, Rebecca Catterson, Emily Alvarez

Behavioral Health, Workforce, Health Care Costs

In late 2023, CHCF and NORC at the University of Chicago conducted a representative, statewide survey of Californians’ health care opinions and experiences, which included an oversample with 1,525 Central Valley respondents age 18 and older.

The 2024 CHCF California Health Policy Survey

Jen Joynt, Rebecca Catterson, Emily Alvarez

Health Care Costs, Health Equity, Homelessness & Health Care, Maternal Health, Behavioral Health

Conducted in fall 2023, this survey collected Californian adults’ opinions and experiences on various health care topics, including mental health, medical debt, racial equity, and more.

Torres Mowat and Deas Join CHCF Board

The California Health Care Foundation (CHCF) announced the election of Kristin Torres Mowat, JD, MBA, and Deborah Deas, MD, MPH, to its board of directors.

National Health Spending Quick Reference Guide — 2024 Edition

Katherine Wilson

Health Care Costs

National health care spending totaled $4.5 trillion in 2022, or $13,493 per person. The Almanac report provides a detailed look at national health care spending.

Three Charts That Help Explain the Financial Health of California’s Hospitals

Health Care Costs

This dashboard, updated quarterly as new data become available, provides estimates of costs and revenue for California hospitals from 2019 to the most recent quarter available.

Expanding the Community Health Worker / Promotor / Representative Workforce

CHW/P/Rs provide culturally congruent, person-centered services that bridge different health and social services systems and improve the health and well-being of the people they serve. CHCF is committed to furthering the integration of CHW/P/Rs into care delivery systems in California.

California’s County-Based Health Plans — 2024 Edition

Katherine Wilson

Coverage Trends

The state's county-based health plans are public entities organized through one or more counties to ensure that Medi-Cal enrollees, and in some cases county employees and Covered California enrollees, receive comprehensive care. Where are these plans and who do they cover?

Behavioral Health Treatment Beds and Housing in California: An Explainer

Kerry Landry, Ed Ortiz

Behavioral Health

Californians with serious mental illness or substance use disorder may face long waits accessing treatment beds or supportive housing. This explainer maps the continuum of behavioral health treatment beds and housing options in California so stakeholders across systems can see the full range of resources.

Top Five Takeaways from CHCF’s 2024 California Health Policy Poll

January 31, 2024

Kristof Stremikis

Behavioral Health, Health Care Costs, Health Equity, Workforce, Homelessness & Health Care

The annual statewide poll offers a comprehensive look at the health issues Californians are most worried about — and what they hope state policymakers will prioritize this year.

Key Takeaways from Medi-Cal Redetermination Data

Coverage Trends

State data from June through November 2023 show that Medi-Cal enrollees who are seniors or have a disability are being disenrolled at a disproportionately high rate.