San Francisco Health Plan Providers Help Earn Statewide High-Quality Care Award for Fifth Straight Year

San Francisco Health Plan announced as the Sole Recipient of the 2012 California Department of Health Care Services GOLD AWARD

Apr 30, 2012, 14:52 ET from San Francisco Health Plan

SAN FRANCISCO, April 30, 2012 /PRNewswire/ -- San Francisco Health Plan (SFHP), a community health plan serving over 75,000 San Francisco residents, announced today that it is the exclusive recipient of the 2012 Gold Award for Excellence in Quality Care from the California Department of Health Care Services (DHCS).

This is the fifth year in a row that SFHP has received the honor.

Award rankings are determined by performance in the Healthcare Effectiveness Data and Information Set (HEDIS), a national set of measures for clinical care delivered to health plan members, developed by the National Committee for Quality Assurance (NCQA). Examples of HEDIS measures include the percentage of children who receive all recommended immunizations by the age of two, and the percentage of women within the recommended age range who have received a mammogram screening for breast cancer.  SFHP was the only health plan out of 21 Medi-Cal managed care health plans statewide that achieved HEDIS scores at or above the high performance levels in 14 of 21 measures, and did not report any scores at the minimum performance level.

"Over the past five years we've implemented unique quality improvement initiatives designed to motivate members to become active participants in their own care," said Hunter Gatewood, Director of Quality and Performance Improvement. "We are promoting population health to ensure everyone gets the right care at the right time, every time."

According to Dr. Kelly Pfeifer, Chief Medical Officer, SFHP is working with providers to develop a new Care Team model.  "Medical assistants and nurses consider it their job to ensure every diabetic gets the services they need.  We are training them to provide health coaching, to help patients make better lifestyle choices.  We're grateful to have a network of providers who share our commitment to improved care at every possible point of contact with the patient.  This honor is first and foremost a reflection of their work," says Dr. Pfeifer.   

Through sharing best practices and technical assistance for providers, and providing outreach and incentives for members, SFHP has become one of the leading community health plans in the state. 

Launched in 1997, the Plan celebrated a milestone of 75,000 members this year.  Combined with individuals served in Healthy San Francisco and SF PATH – the City's non-insurance programs that are administered by SFHP – the Plan provides services to approximately 130,000 residents of San Francisco, or over 16% of the entire population of San Francisco.    

"Since our beginning 15 years ago, an uncompromised dedication to quality care has been an enduring core value of San Francisco Health Plan," said John F. Grgurina, Jr., CEO of San Francisco Health Plan.  "That we've received this honor for the fifth year in a row is a testament to that promise of excellence, and I could not be more proud to work alongside this network of providers, our Governing Board, and the entire SFHP team.  We are once again humbled by the honor, and grateful to the California Department of Health Care Services for the recognition."

The HEDIS 2012 Gold Award reflects results reported to the state in 2011.

About San Francisco Health Plan

San Francisco Health Plan, a licensed community health plan providing affordable health coverage to over 75,000 low and moderate-income families residing in San Francisco. 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. San Francisco Health Plan is also the third party administrator for the nationally recognized Healthy San Francisco program.  For more information on SFHP, visit

SOURCE San Francisco Health Plan