Medi-Cal Managed Care

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.

State Must Write New Medi-Cal Contracts to Advance Health Equity

January 20, 2021

Anne Sunderland

Health Equity, Medi-Cal

An interview with Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Network.

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.

America’s Health Was on the Ballot

November 10, 2020

Sandra R. Hernández

Health Equity, Medi-Cal

The new administration must ensure that our health care system delivers the respect, dignity, compassion, and quality that have long been denied to far too many Americans.

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

Melissa Buckley

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.

How California Could Encourage Adoption of Alternative Payment Models

October 14, 2020

Payment & Financing, Health Care Costs, Medi-Cal

Research has shown that APMs can help reduce costs and improve quality.

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).

CIN Resource Page: Addressing Social Needs That Impact Health

This California Improvement Network resource page focuses on tools and strategies for improving health outcomes by addressing patients’ social needs, including how to prioritize social needs strategies, supporting staff in effectively addressing social needs, and building partnerships with community-based organizations.