Medi-Cal Managed Care
San Diego: Competing, Collaborating, and Forging Ahead with Population Health
Caroline Davis, Katrina Connolly
The San Diego health care market has long been dominated by four health systems: Kaiser Permanente, Sharp HealthCare, Scripps Health, and University of California San Diego Health. Despite significant gains in health coverage, access to care for people with lower incomes, especially for behavioral health services, remains a challenge.
Reimbursing FQHCs for Telehealth Post-COVID-19 Pandemic: Medi-Cal’s Options
Pacific Health Consulting Group
This paper examines the choices and considerations for California policymakers to extend Medi-Cal coverage and reimbursement for telehealth provided by Federally Qualified Health Centers — even after the COVID-19 pandemic.
Paying Medi-Cal Managed Care Plans for Value: Design Recommendations for a Quality Incentive Program
Medi-Cal, Payment & Financing
This report recommends a new way to pay Medi-Cal managed care plans (MCPs) designed to improve the quality of care for Medi-Cal enrollees. The Department of Health Care Services would withhold part of its capitation payments to MCPs, who could earn back some or all of the amount withheld depending on their performance on quality measures.
San Joaquin Valley: Despite Poverty and Capacity Constraints, Health Care Access Improves
Len Finocchio, James Paci
Federally Qualified Health Centers and Rural Health Clinics continue to expand across the region. They are also working with hospitals to improve care integration and access to specialty services for Medi-Cal patients.
Inland Empire: Increasing Medi-Cal Coverage Spurs Safety-Net Growth
Matthew Newman, James Paci
Following the implementation of the Affordable Care Act, this region, comprising Riverside and San Bernardino Counties, has seen a decrease in people who are uninsured and an increase in people with Medi-Cal coverage. In turn, the number of Federally Qualified Health Centers has grown, and patient visits more than doubled in just a few years.
Mental Health Disparities by Race and Ethnicity for Adults in Medi-Cal
California Pan-Ethnic Health Network
Behavioral Health, Medi-Cal, Health Equity
A 2017 California law requires robust tracking and evaluation measures for mental health services in Medi-Cal. This report demonstrates mental health access disparities for adults enrolled in Medi-Cal.
Improving Quality in Medi-Cal Managed Care
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.
Health Organizations Advise DHCS on Recontracting with Medi-Cal Health Plans
On September 1, 2020, the California Department of Health Care Services (DHCS) requested input on proposed changes to Medi-Cal managed care contracts. CHCF has collected various health organizations' responses, as they collectively reflect important thinking on how DHCS can recontract with health plans in a way that advances several critical improvements to Medi-Cal managed care.
Humboldt and Del Norte Counties: Community Collaboration in the Face of Health Adversity
Jill Yegian, Katrina Connolly
The rural North Coast California counties of Humboldt and Del Norte face multiple health and health care challenges, including high death rates from preventable causes and shortages of health care providers. The region is addressing these challenges through strong collaborative efforts.
Dual Purpose: Opportunities for Technology to Help People Enrolled in Medicaid and Medicare
October 30, 2020
Investing in Innovation
A conversation with Andrey Ostrovsky, MD, an angel investor and former chief medical officer of the federal Center for Medicaid and CHIP Services.
Californians with Low Incomes Struggle to Navigate Both Medi-Cal and Medicare
October 28, 2020
Amber Christ, Georgia Burke
Medi-Cal, Health Equity, Older Adults with Complex Needs
One might think dual enrollment in Medicare and Medi-Cal should provide relief from health coverage worries, but many of the 1.4 million Californians with low incomes who are enrolled in both programs find it as much a struggle as a help.
Getting to Care: A Look at Medi-Cal’s Transportation Benefit
Athena Chapman, Elizabeth Evenson, Len Finocchio, Shawn Blosser
In 2016 California lawmakers expanded Medi-Cal coverage to provide more comprehensive coverage for the cost of transportation to medical services. This report provides an overview of the implementation and experiences of this expanded benefit.