Medi-Cal Explained - California Health Care Foundation

Medi-Cal Explained
Medi-Cal is the foundation of California’s health care safety net and a major component of the state’s budget. The Medi-Cal Explained series provides an overview of the program, including the people it serves, the services it provides, and how it is organized, managed, and financed.

The Medi-Cal Program: An Overview

Margaret Tatar, Health Management Associates, Athena Chapman, Chapman Consulting

This publication offers an overview of the Medi-Cal program, which provides health coverage in California for children and their parents with low incomes, pregnant women, seniors, and nonelderly adults, including people with disabilities.

Medi-Cal Explained: What Are Alternative Payment Models?

Athena Chapman, Samantha Pellón

This issue brief explores how Medi-Cal has been developing alternative payment models to align with federal initiatives and state financial and policy goals. It looks at the benefits of these models and barriers to their adoption.

Medi-Cal Explained: How Health Centers Are Paid

Athena Chapman, Samantha Pellón

Learn about payment methods for community health centers and Federally Qualified Health Centers, including prospective payment system reimbursement.

Medi-Cal Explained: Managed Care Plan Procurement

Mari Cantwell, Sarah Brooks

Medi-Cal, Payment & Financing

This brief explains what the 2021 Medi-Cal managed care reprocurement process is and what it means for millions of Californians served by Medi-Cal.

2021 Edition — Medi-Cal Facts and Figures

Len Finocchio, James Paci, Matthew Newman, Blue Sky Consulting Group

Medi-Cal, Coverage Trends

Medi-Cal, California’s Medicaid program, is the state’s health insurance program for Californians with low incomes, including children, people with disabilities, and seniors. Get the latest data on this program, which covers one in three Californians.

Long-Term Services and Supports in Medi-Cal

Athena Chapman, Elizabeth Evenson

Millions of Californians covered by Medi-Cal live with disabling conditions or chronic illnesses and require assistance with common activities of daily living, such as bathing, dressing, and eating. In California, a patchwork of programs provide services to help these people; they are known as long-term services and supports (LTSS).

Maternity Care and Paying for Maternity Services

Medi-Cal, Maternal Health

Learn about maternity coverage in Medi-Cal, including eligibility, covered services, and payment.

Medi-Cal Waivers and State Plan Amendments

Two short documents provide an overview of Medicaid waivers and State Plan Amendments, and how they are used in California. A one-page comparison chart shows the differences between these two policy instruments.

October 24, 2019

Webinar — Medi-Cal Explained: Waivers and State Plan Amendments

October 24, 2019

As California is set to launch the California Advancing and Innovating Medi-Cal (CalAIM) initiative, brush up on the fundamentals of waivers and State Plan Amendments, including what's in California's current Section 1115 and Section 1915(b) waivers.

Medi-Cal Eligibility and Enrollment: Current Status and Challenges

Health Management Associates

This fact sheet provides an overview of the eligibility determination and enrollment process for the Medi-Cal program.

Medi-Cal Payment to Managed Care Plans: Current Process and Challenges

Health Management Associates, Athena Chapman, Chapman Consulting

This fact sheet provides an overview of Medi-Cal managed care plans and how they are structured.

Medi-Cal and Behavioral Health Services

Health Management Associates

Medi-Cal, Behavioral Health

This fact sheet provides a high-level overview of how mental and behavioral health issues are managed in the Medi-Cal program.

The Medi-Cal Budget

Health Management Associates

This fact sheet describes the organization, funding sources, and process for developing the Medi-Cal program budget.

February 25, 2019

Briefing — Medi-Cal Explained: An Overview of Program Basics

February 25, 2019

This briefing provided an overview of the basics of the Medi-Cal program, including eligibility and enrollment, organization, oversight, and financing.

Accountability in the Medi-Cal Managed Care Program

This fact sheet provides an overview of how the Department of Health Care Services assesses quality of care provided by the more than 30 full-service and specialty managed care plans that participate in Medi-Cal's managed care program.