San Francisco Health Plan Organized for Expansion to Serve More Seniors and People With Disabilities

Mar 31, 2011, 13:22 ET from San Francisco Health Plan

The State-mandated transition of seniors and people with disabilities from fee-for-service Medi-Cal to managed care offers an estimated 17,000 a choice of an award-winning, local health plan

SAN FRANCISCO, March 31, 2011 /PRNewswire-USNewswire/ -- San Francisco Health Plan (SFHP), the city's community health plan that serves over 60,000 residents, announced it is prepared for an expansion of its member population to serve thousands of seniors and people with disabilities.

The California Department of Health Care Services' five-year federal waiver (Section 1115(a) of the Social Security Act) mandates enrollment of non-Medicare seniors and people with disabilities into Medi-Cal managed care health plans. The goals of the transition include better care coordination, optimal management of chronic conditions and improved health outcomes.

SFHP has been working to ensure that the needs of seniors and people with disabilities will be met by providing timely access to physicians and specialists, language assistance, alternative format materials, physical accessibility into and within medical offices and clinics among other needs and requirements.

"We have been working tirelessly for months and are well prepared to meet the needs of our growing member population. We've overseen the readiness of our provider network, performed health assessments and engaged with senior and disabled advocacy groups to help us develop best-practices and meet expectations. In the end, we are going to provide what SFHP has become well known for: providing the best care possible to our members," said John F. Grgurina, Jr., CEO of San Francisco Health Plan.

SFHP will provide coordination of care, including specialist referrals, a 24/7 nurse advice line, customer service, and care management to ensure its growing member populations receive the high quality coordinated health care that all current SFHP Medi-Cal members receive.

"This truly is an opportunity to achieve the triple aim: improved health, improved health care, and at an affordable cost," added Medical Director Kelly Pfeifer.

The staggered enrollment by the State Medi-Cal program will be over a twelve-month period, with SFHP taking in approximately 1,200 new seniors and people with disabilities in June 2011 and an estimated 15,000 members through June 2012.

About San Francisco Health Plan

San Francisco Health Plan, a licensed community health plan providing affordable health coverage to over 60,000 low and moderate-income families residing in San Francisco. SFHP is also the third-party administrator for Healthy San Francisco, a program that provides access to health care services for 55,000 San Francisco residents.  SFHP was designed for and by the residents it serves – many of whom would not be able to otherwise obtain health care for themselves or their families. Through SFHP, members have access to a full spectrum of medical services including preventive care, hospitalization, prescription drugs, family planning, and substance abuse programs. SFHP's mission is to provide superior, affordable health care emphasizing prevention and promoting healthy living with the goal of improving the quality of life for the people of San Francisco. For more information on SFHP, visit

SOURCE San Francisco Health Plan