Health Equity

CalPERS exceeded our goal of collecting 100,000 Health Demographic Profiles.

• The Health Demographic Profile is an electronic survey in myCalPERS that gathers self-reported health demographic information for health plan enrolled CalPERS members 18 years and older.
• The data collected will be used to identify inequalities and learn if health outcomes, member experience of care, and/or preventative care differ based on demographics.
• Information from the Health Demographic Profiles will be used to direct programs, policies, and interventions on behalf of our members.

Developed the Health Equity Index Strategic Measure to monitor progress on our health equity work.

• Added the Achieving Health Equity strategic measure to the 2022-2027 Strategic Plan (PDF, 1.3 MB) that focuses on health equity using a Health Equity Index (HEI).
• HEI milestones foster health equity by creating a consistent infrastructure for improving outcomes, narrowing health disparities, and creating a culture of health equity for CalPERS members.

Updated the 2024 Health Benefit Design (PDF) to improve health care access, affordability, equity, and quality.

• Implemented a site of care member incentive program for labs to decrease cost variation and improve affordability of lab services for members in our Basic Preferred Provider Organization (PPO) plans. This will reduce or eliminate member out-of-pocket expenses and contribute to improved long-term affordability of the PPO program.
• Educated members about the pharmacy home delivery benefit for non-specialty medications, with the ability to opt-out.

CalPERS continued implementing contract requirements and working with Health Maintenance Organization (HMO) health plans to accelerate provider and health plan efforts to achieve health equity.

• Required plans to develop and maintain a Member Advisory Committee (PDF) that is reflective of our membership.
• Required health equity accreditation of our plans, through the National Committee for Quality Assurance (NCQA), by 2025.
• Updated our 2024 clinical quality measure set to align with Covered California and the Department of Health Care Services, and required plans to stratify measures by member demographics.

The work being done at CalPERS resulted in positive impacts to members' health care experiences, access, equity, affordability, screening, and management. In last year's Commitment to Diversity, Equity, and Inclusion Report, we shared some of the work done by our Health Program team. This year, we acknowledge the changes that have officially gone into effect and were shared via PERSpective, an online news source for CalPERS members and beneficiaries.

• Reproductive Health Equity Language Change: New benefit language providing all members access to reproductive health benefits regardless of sex, sexual orientation, or gender identity.
• Fertility Care Language Change: New benefit language updating the definition of infertility to provide access to infertility treatment to members regardless of age, sexual orientation, gender identity, or marital status.
• Hearing Aids Benefit Adjustment: New benefit for members under the age of 26, providing medically necessary and clinically appropriate hearing aids in both ears at 100% coverage every 36 months.