Medi-Cal Managed Care
A Close Look at Medi-Cal Managed Care: Statewide Quality Trends from the Last Decade
Philip R. Lee Institute for Health Policy Studies at UCSF
This report examines the quality of care provided by Medi-Cal managed care plans between 2009 and 2018. In addition to reporting on overall trends in performance, this report also examines differences by type of ownership (public, nonprofit, for-profit) and model of managed care.
A Close Look at Medi-Cal Managed Care: Stories of Quality Improvement Success
Athena Chapman, Caroline Davis
This paper highlights examples of Medi-Cal managed care plans that have made significant progress on individual quality-of-care measures. The paper identifies several common, interconnected strategies that were key to improving quality and provides concrete examples of how plans put these strategies into place.
2019 Edition — California’s County-Based Health Plans
The state's county-based health plans are public entities organized through one or more counties to ensure that Medi-Cal enrollees, and in some cases county employees and Covered California enrollees, receive comprehensive care. Where are these plans and who do they cover? How have they changed between 2012 and 2018?
Opioid Safety Lessons Put Physician on Path to State Policymaking
July 25, 2019
After five years leading CHCF's High-Value Care Team and its opioid safety portfolio, Kelly Pfeifer, MD, will become deputy director of mental health and substance use disorder services for California state government.
Integrated Physical and Behavioral Health in Medicaid Managed Care
Logan Kelly, Michelle Conway, Michelle Herman Soper
This brief distills insights from providers in three states — Arizona, New York, and Washington — that have recently transitioned to integrated managed care for physical and behavioral health conditions. It was written by the Center for Health Care Strategies with support from the Blue Shield of California Foundation and CHCF.
Quantifying Integrated Physical and Behavioral Health Care in Medi-Cal
Blue Sky Consulting Group
How well does the Medi-Cal program meet the needs of patients who require both physical and behavioral health care services? Blue Sky Consulting Group has identified measures that plans and providers can use to monitor health outcomes for people who access care across multiple systems.
State Releases Data on 2018 Health Insurance Enrollment
June 28, 2019
New data on California health insurance markets show overall enrollment changed little from 2017 to 2018, as declines in Medi-Cal managed care and the individual market were mostly offset by increased membership in employer-sponsored small- and large-group plans.
How California Can Use Purchasing Power and Oversight to Improve Quality in Medi-Cal Managed Care
Medi-Cal, Payment & Financing
This paper recommends how the California Department of Health Care Services can strengthen its purchasing strategy and oversight to drive quality improvement in Medi-Cal managed care.
Paying Medi-Cal Managed Care Plans for Value
Many states use financial incentives tied to quality of care and other measures of performance in their Medicaid managed care programs. This paper outlines a measure set and performance evaluation methodology that California could use as part of a financial incentive program to drive quality improvement in Medi-Cal managed care.
For Californians Most in Need, Whole Person Care Pilots Break Down Barriers
April 25, 2019
Behavioral Health, Data Exchange, Medi-Cal
Whole Person Care pilots are gaining momentum and have attracted more than 100,000 enrollees so far. The pilots could make significant improvements in care for the most vulnerable Californians.