Community advocates in Ventura County say that too many low-income residents who would qualify for the Gold Coast Health Plan -- the county's new Medi-Cal managed care plan -- do not know how to obtain coverage, the Ventura County Star reports. Medi-Cal is California's Medicaid program (Kisken, Ventura County Star, 11/29).
Background
Earlier this year, California directed counties to modify the state-run Medi-Cal system into locally administered managed care organizations (California Healthline, 4/12). Under the change, health care providers in locally operated managed care plans will be reimbursed at a fixed amount per patient instead of being paid based on the services provided (Ventura County Star, 11/29).
In May, the California Department of Health Care Services gave approval to Ventura County's plan to transform its Medi-Cal program into a managed care system. Under the Gold Coast Health Plan, patients can choose or be assigned a primary care physician who will coordinate their care (California Healthline, 5/13).
Debating Outreach Initiatives
Residents attended a meeting on Monday of the Ventura County Medi-Cal Managed Care Commission to discuss the program.
May Lee Berry -- a member of the managed care commission who represents low-income Medi-Cal beneficiaries -- said patients who do not have a primary care physician and are not already part of the Medi-Cal system might encounter difficulties transitioning into Gold Coast. She said a recently hired outreach specialist should work to educate residents about Medi-Cal.
Marco Benitez -- a community advocate who hosts a bilingual radio talk show -- said, "Nobody knows how to get the services."
Meanwhile, representatives from Healthy Families -- which is the state's Children's Health Insurance Program -- and the Greater Los Angeles Agency on Deafness praised the new health plan for its efforts to help residents understand the new system.
Steve Lalich -- Gold Coast Health Plan's communications director -- said outreach efforts have included 50 information sessions and town-hall meetings, as well as a radio campaign that aired more than 3,700 commercials (Ventura County Star, 11/29).