Covered California
Reducing health disparities and care gaps through peer & collaborative learning
Covered California is investing in stronger data infrastructure and population health practice across its qualified health plans to reduce care gaps and advance health equity. The Population Health Learning Center supports that investment through a Community of Practice focused on the operational work of using data well: acquiring it, exchanging it, and acting on it to close gaps in care. Participating organizations are aligning their work with the California Data Exchange Framework while building the workflows that translate data into better outcomes for members.
We are working with them to:
- Increase in practice acquisition of external data sources essential for improving HEDIS-like measures.
- Increase the number of care gaps that are closed during 12 months for HEDIS-like measures by at least 20% from baseline .
- Use data to stratify HEDIS-like measures to identify a disparity, develop an action plan to reduce the disparity and then make progress on related goals.
Project At A Glance
Timeline
2025 – 2026
Project Stage
Implementation
Partners
Connecting for Better Health
FUNDER
Covered California
Learning center services
What’s happening now
Practices, managed care plans, and qualified health plans are co-designing improved workflows for exchanging clinical information and using it to support timely follow-up care. Working alongside Connecting for Better Health, participants are developing implementation playbooks that move organizations from current-state workflows to scalable future-state models. Peer learning and expert coaching are helping organizations strengthen acquisition of external clinical data, improve performance on HEDIS-like quality measures, and develop targeted strategies to reduce disparities. One participant described the initiative as “a real operational shift” that produced a clear, actionable plan for improving data-sharing and follow-up care.
What we’re learning
The organizations closing care gaps fastest treat data exchange as a workflow problem, not only a technology problem. Acquiring external clinical data is the starting point, but the real operational lift sits in redesigning follow-up workflows, panel management routines, and the handoffs between health plan, practice, and community partners. Participants have also been clear that protected time and outside facilitation are what allow this redesign work to happen at all. Without structured space away from day-to-day operations, the same workflow gaps persist even when the underlying data infrastructure improves.
Previously, we were losing data. Now, we can easily share data, helping us screen AND follow up for Depression. The sessions allowed us to step back from daily operations and think critically about the workflow & we are seeing measurable improvements. We walked away with a clear, actionable plan. A real, operational shift. This was a first for me.. Overall, PHLC is supporting us, not just evaluating us.”