Medi-Cal Rate Cuts


Medi-Cal Cuts Undermining Senior Programs, Facilities, Advocates Say

Protestors carry signs against proposed Medi-Cal cuts outside San Francisco city hall in  2011 in San Francisco. (Justin Sullivan/Getty Images)

Protestors carry signs against proposed Medi-Cal cuts outside San Francisco City Hall in 2011 in San Francisco. (Justin Sullivan/Getty Images)

By David Gorn, California Healthline

The irony of the situation was not lost on Linda Trowbridge, CEO of the Center for Elders’ Independence in Oakland.

At an Assembly hearing in Sacramento last week, Trowbridge said funding for California’s Program of All-Inclusive Care for the Elderly — or PACE — has been systematically cut over the past six years and yet it is often cited as the model of care the state would like to pursue.

“Adult day health care is essentially skilled nursing care in a community setting, and this Medi-Cal rate reduction threatens our whole industry.”
The federally subsidized program is aimed at providing and coordinating care to allow seniors and people with disabilities to remain living at home.

“Everybody who is in this program would otherwise be in a skilled nursing facility,” Trowbridge said. The program saves the state money, she said, pointing to estimates that PACE centers cost 11 percent of what it would cost to have people go to nursing facilities. Ironically, the PACE program is one of the state’s models for its Coordinated Care Initiative for dual eligibles, Trowbridge said. Continue reading

Pharmacies Braced for Cuts to Their Medi-Cal Payments

(Getty Images)

(Getty Images)

Pharmacies across the state are bracing for a blow to their revenues. Starting Friday, Medi-Cal –the state’s health coverage for low-income patients — will start paying 10 percent less for filling certain prescriptions. Though the number of drugs affected is less than originally outlined, pharmacists are still worried.

Many of them say there is a misconception that they make loads of money selling drugs. But after they pay pharmaceutical companies for the medications they stock, there’s little profit left, they say. An additional cut could put them in the red on some drugs.

“The margin in drug products is roughly 2 to 4 percent,” says Jon Roth, CEO of the California Pharmacists’ Association. “If you’re looking at a 10 percent reduction, you’re immediately upside down and dispensing medication at a loss.” Continue reading