Medi-Cal Managed Care

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State Set to Move Rural Seniors, Disabled to Medi-Cal Managed Care

(Ben Ramirez: Flickr)

(Ben Ramirez/Flickr)

By David Gorn, California Healthline

About one month from now, the state is launching a program to shift a new set of Medi-Cal beneficiaries into Medi-Cal managed care plans. This time, the state is focusing on a shift in care for some of the frailest patients in rural counties.

Among many of these frail beneficiaries, there is deep fear about what’s about to happen.

On Dec. 1, about 20,000 Medi-Cal seniors and persons with disabilities in 28 rural counties will make the switch to managed care plans. It’s a continuation of an extended effort by the state to expand Medi-Cal managed care to rural areas, said Mari Cantwell, chief deputy director of health care programs at the Department of Health Care Services, which oversees Medi-Cal.

“We started the rural expansion about a year ago, starting with non-disabled adults and children in 28 counties,” Cantwell said. “Still pending are the population of seniors and persons with disabilities (SPD’s). That’s not a very large number of people in comparison, about 20,000 people.” Continue reading

Last Phase of Transition: Rural Californians Move to Medi-Cal Managed Care

(Ben Ramirez: Flickr)

(Ben Ramirez/Flickr)

By David Gorn, California Healthline

Rural Californians already have challenges accessing health care and changes to Medi-Cal, the state’s Medicaid program, could further complicate matters.

Rural areas have fewer physicians and facilities and services are spread out over greater distances than they are in urban and suburban areas. Rural areas also have a disproportionately high number of lower-income, Medi-Cal-eligible residents which creates a challenging situation for state health officials charged with providing medical coverage in rural settings.

“The rollout has gone relatively smoothly, but the access to providers — that’s a real question still.”

On Nov. 1, the state launched an ambitious plan to transition Medi-Cal beneficiaries in rural areas from fee-for-service care arrangements to managed care plans. The move shifts 28 rural counties to the financial model the state is using throughout the rest of the state.

Also on Nov. 1, the state launched the last phase of its Healthy Families transition — moving children in rural counties to Medi-Cal managed care. Healthy Families is California’s Children’s Health Insurance Program. Continue reading