Six Things to Watch For Now That DHCS Has Selected Commercial Medi-Cal Managed Care Plans
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THE CHCF WEEKLY
September 13, 2022
The Department of Health Care Services (DHCS) took a major step in its efforts to transform Medi-Cal last month when it announced which commercial Medi-Cal managed care plans it will contract with starting in 2024.
On The CHCF Blog, Chris Perrone, director of Improving Access, says that DHCS deserves praise for setting some of the boldest improvement goals of any state Medicaid agency. He outlines six factors that will influence whether those goals are achieved:
1. The transition of potentially more than 2 million Medi-Cal enrollees to new plans in 2024
2. Plans’ success in building out provider networks
3. Exiting plans’ commitment to Medi-Cal transformation throughout 2023
4. The strength of financial incentives tied to quality
5. Transparency on plan performance and Medi-Cal’s progress
6. State investment in the health care workforce
From the Blog
Brian Rinker In California, some health care organizations are turning to a start-up company that offers incentives to unhoused people to engage with case management and medical care. |
Dana G. Smith Telehealth could extend care to millions of underserved people — but only if they can access it. |
Recent Release
This publication summarizes seven state plan amendments, including California's, submitted to the Centers for Medicare & Medicaid Services to authorize community health workers to serve a broad Medicaid population.
Partner Spotlight
Many aging adults and people with disabilities will need support and assistance throughout their lifetimes. Medi-Cal is an important payer for home and community-based services. This report is the first in a series on building equity in long-term care.
Stories That Caught Our Attention
- Unanswered Cries: Why California Faces a Shortage of Mental Health Workers (CalMatters)
The need for therapists, social workers, psychologists, and psychiatrists is greater than ever. With providers in short supply, experts explain how California got here — and where it may be headed. Related: Learn more about the number of licensed mental health professionals in California in this recent CHCF publication.
- Hospitals Divert Primary Care Patients to Health Center ‘Look-Alikes’ to Boost Finances (California Healthline)
Medicare and Medicaid pay these clinics, known as Federally Qualified Health Center Look-Alikes, significantly more than they would if the sites were owned by hospitals.
- Diversifying California’s Doctors (Inside Higher Ed)
A new program seeks to create a pathway from California community colleges to medical schools. Advocates hope it will lead to a more diverse population of doctors and address acute regional physician shortages. Related: Programs in Medical Education (PRIME) at University of California schools statewide have for many years addressed the medical needs of specific underserved communities, according to an article on The CHCF Blog.
- Venture Capital Firms Lure Health System CEOs (Modern Healthcare — Podcast)
Many CEOs of health systems delayed retirements or job changes during the pandemic. Now we're seeing a wave of top executive departures across the sector.
- Why Didn’t More Americans Use COVID-19 Exposure Notification Apps? (Slate)
More than 9.9 million cases of COVID-19 have been reported in California, and the official death toll has surpassed 92,000. How receptive were Californians to using the technology tools and apps developed to help them stay healthy and safe in the pandemic? Related: This CHCF Blog post explains how California's exposure notification app, CA Notify, works.
- Travel Nurses' Gold Rush Is Over. Now, Some Are Joining Other Nurses in Leaving the Profession Altogether. (NBC News)
During the COVID-19 pandemic, nurses tripled their pay by moving from job to job. But the short-lived boom was a temporary fix for a long-term decline in the nursing profession. Related: In a CHCF interview, a health workforce expert describes the major impact of the pandemic on the supply of providers.
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