In 2021 the California Department of Health Care Services will begin the process of recontracting with Medi-Cal managed care plans (often referred to as procurement). It's a critical opportunity to use new financial incentives and oversight measures to improve quality and access to care for Medi-Cal members.
Over 80% of all those in Medi-Cal (more than 10 million Californians) are enrolled in a managed care plan. Everyone in Medi-Cal, regardless of where they live or their managed care plan, should have the same opportunity to get timely, high-quality care. But today, access and quality of care varies widely within the Medi-Cal managed care system. Variation in quality and access across plans, and by other factors such as race and ethnicity, means some enrollees are much more likely than others to get life-saving preventive care or essential treatment for chronic conditions.
This collection highlights research into the quality of care in Medi-Cal managed care and potential solutions that can be pursued by the Department of Health Care Services during the recontracting process with managed care plans to improve quality and reduce disparities.
Medi-Cal: California Has a Rare Opportunity to Improve Health Care Equity
Paying Medi-Cal Managed Care Plans for Value: Design Recommendations for a Quality Incentive Program
Health Organizations Advise DHCS on Recontracting with Medi-Cal Health Plans
Medi-Cal’s System for Children’s Health Care Is Broken; Newsom Can Help Fix It
In this CalMatters commentary, Children Now recommends how the Newsom Administration can re-contract with Medi-Cal managed care plans to improve quality and access for the state’s children enrolled in Medi-Cal.
Children’s Medi-Cal Managed Care in California Counties
There is wide variation across the state and even within counties in managed care plan success in ensuring children get the services they need to get or stay healthy. Children Now analyzed county- and plan-level data to develop 58 county landscapes of Medi-Cal managed care for children.