Health Network Enrollment

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Department of Public Health

FY 2016-17
Target: 93,000 participants by fiscal year 2020-21
Target Status:
MEETING TARGET

FY 2016-17
Average: 94,006 participants

The San Francisco Health Network (SFHN) is a comprehensive system of care, overseen by the Department of Public Health (DPH). It includes primary and specialty care, dentistry, emergency and trauma treatment, skilled nursing and rehabilitation, and behavioral health. The SFHN is made up of the Priscilla Chan and Mark Zuckerberg San Francisco General Hospital and Trauma Center, Laguna Honda Hospital and Rehabilitation Center, as well as numerous DPH-run primary care clinics throughout the city.

This measure represents all managed care members, including Medi-Cal and Medi-Cal Expansion members, in the SFHN who use primary care and/or other network services. Members also come from other health care coverage programs, such as Healthy Workers and Healthy Kids, and health care access programs in the city, such as Healthy San Francisco (HSF). Tracking enrollment helps SFHN leadership to make decisions that work towards improving health care delivery and member experience, allowing resources to be effectively allocated and better serve members.

OVERALL ENROLLMENT IN THE SFHN REMAINED CONSTANT IN RECENT MONTHS

How the Department of Public Health is Performing

The San Francisco Health Network (SFHN) experienced significant growth over several years, but overall enrollment has plateaud since November 2016. The SFHN was established in June 2013 with a baseline of just over 81,000 enrollees. Overall enrollment has slightly fluctuated month-to-month. Assuming a 1.75 percent increase in enrollment each year, the Department of Public Health (DPH) projects that SFHN enrollment will reach 93,000 by fiscal year 2020-21, with an increasing proportion of membership covered by new insurance programs created under the Affordable Care Act (ACA).

The major provisions of the ACA were implemented in January 2014. While SFHN total enrollment has fluctuated slightly from month to month, the make-up of enrollees has changed. With the implementation of the ACA, many HSF participants became newly eligible for insurance through Medi-Cal Expansion starting January 2014. As a result, the number of SFHN Medi-Cal Expansion enrollees has increased significantly, while the number of HSF participants has decreased. SFHN is actively seeking to partner with a Covered California health plan in order to serve as a health care provider for Covered California members.

Enrollment in San Francisco Health Network's Healthy Kids program decreased significantly in Fiscal Year 2016-17, down from about 1,300 in July 2016 to less than 300 by October 2016. This decrease was part of a planned transition as many children under 19 years of age became eligible for full-scope Medi-Cal benefits regardless of immigration status, under California's SB75 legislation. The change in enrollment is reflected in a slight decrease in the "Other" category in the chart above, and a slight increase in Medi-Cal enrollment.

How Performance is Measured

Enrollment numbers count the number of unique, eligible, enrolled members in each health plan. Each health plan transmits a membership file with this information to DPH on a monthly basis.

The number displayed on the scorecard page represents a fiscal year average of the values in the chart above.

Additional Information

Data

Please visit DataSF for the scorecard data.