Medi-Cal Managed Care

October 11, 2022

Webinar – A National Conversation on a Measurement Framework for Accountability in Medicaid

Health Equity, Medi-Cal

October 11, 2022

The National Committee for Quality Assurance (NCQA), with support from CHCF, has developed a health equity measurement framework that state Medicaid programs can use to measure accountability in health plan managed care contracting. Join NCQA on October 11 for a conversation on how this framework can be leveraged to promote equity in Medicaid and beyond.

Advancing Health Equity: A Recommended Health Equity Framework for Accountability in Medicaid

National Committee for Quality Assurance

Health Equity, Medi-Cal

With support from CHCF, the National Committee for Quality Assurance (NCQA) developed a health equity measurement framework that state Medicaid programs can use to measure accountability in health plan managed care contracting.

Six Things to Watch For Now That Medi-Cal Has Picked Commercial Managed Care Plans

September 8, 2022

Christopher Perrone

Health Equity, Medi-Cal

Continued investment and sound implementation will lead to higher quality care for millions of Medi-Cal enrollees — and progress toward reducing racial and ethnic disparities in outcomes.

Investing in Primary Care: Why it Matters for Californians with Medi-Cal Coverage

Edrington Health Consulting

This first-of-its-kind study examines primary care spending by 13 Medi-Cal managed care plans and finds that greater investment in primary care is associated with better quality of care and a higher plan rating.

My Comments on the Healthy California for All Commission’s Final Report

Sandra R. Hernández

Expanding Health Coverage, Health Care Costs, Workforce, Medi-Cal, Data Exchange

CHCF's president and CEO, who was appointed to the commission by Governor Gavin Newsom, shares her thoughts on the panel's report.

Improving Behavioral Health Systems Through Operational Integration: Efforts in San Mateo County

Behavioral Health

In San Mateo County, the Medi-Cal managed care plan and the behavioral health plan are working together to streamline operational functions to better manage resources and improve member care.

California Spent Millions to Boost COVID-19 Vaccination Rates of Medi-Cal Members — But They Lag Even More

Medi-Cal, Homelessness & Health Care

Gaps in COVID-19 vaccination rates among the state’s Medi-Cal population persist. Five Medi-Cal plans still have vaccination rates under 50%.

CalAIM for Seniors and People with Disabilities

CalAIM, a multiyear initiative to transform the Medi-Cal program, includes a special focus on improving care for seniors and people with disabilities. To make the most of CalAIM, this series elevates experiences and lessons learned from past efforts to integrate and improve care for seniors and people with disabilities in California and other states.

Webinar — Opportunities for CalAIM to Support Community Living

Through CalAIM, Medi-Cal managed care plans have new opportunities to coordinate and deliver person-centered services. During this webinar, the authors of two recent CalAIM reports will discuss how Community Supports and the institutional long-term care carve-in are positioned to work together to enable more Medi-Cal enrollees to live well in the setting of their choice.

CalAIM Community Supports: Promoting Independent Living Among Older Adults and People with Disabilities

Older Adults with Complex Needs

Through CalAIM, Medi-Cal managed care plans now have the option to offer any of 14 Community Supports that provide person-centered services. This report provides an overview of and evidence summary for six Community Supports most relevant to supporting independent living for older adults and people with disabilities.

Expanding Substance Use Care: Health Plan Teams Up with Seven California Counties

Behavioral Health

In this regional Drug Medi-Cal Organized Delivery System program, the counties provide financial resources, and Partnership HealthPlan of California administers the program.

CalAIM and Institutional Long-Term Care: Lessons for Medi-Cal Managed Care

Center for Health Care Strategies, Decipher Health Strategies, Chapman Consulting

Older Adults with Complex Needs

Starting January 1, 2023, California's CalAIM reform initiative will require that care in nursing homes and other institutional settings be provided as a "carve-in" benefit through Medi-Cal managed care plans statewide. This report describes challenges, opportunities, and lessons learned from select California counties and other states where institutional long-term care has already been administered by managed care plans.

Medi-Cal Quality Strategy Explores Bold Steps Toward Health Equity

January 26, 2022

Christopher Perrone

The strategy will shape how health care will be provided to almost one in three Californians.

Network Adequacy Standards in California: How They Work and Why They Matter

Amy Y. Gu, Michele Ellson, Katherine L. Gudiksen

Health Care Costs

In California, both state and federal laws impose provider network adequacy standards on health plans to ensure that the plans provide meaningful access to health care for enrollees. Yet these standards may put plans at a competitive disadvantage when negotiating contracts with providers such as specialists in short supply. This issue brief outlines considerations for policymakers.

Whole Person Care Pilots Set the Stage for CalAIM

December 9, 2021

Increased community collaboration improves outcomes and saves money for payers.