Assembly Committee Examines State's Moves to Medi-Cal Managed Care

by David Gorn

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The Assembly Committee on Health last week asked for a progress report and assurances from Department of Health Care Services officials that the state was not only ready to move many Medi-Cal beneficiaries into managed care, but also ready to evaluate the process.

"The purpose of this hearing is to focus on what's happening with the outcomes and evaluations of our various transitions," said the new chair of the Assembly Committee on Health, Richard Pan (D-Sacramento).

"There are four major transitions in California -- the SPDs [seniors and persons with disabilities], the dual eligibles project [also known as the Coordinated Care Initiative, or CCI], taking our Healthy Families program into managed care and taking our rural communities into managed care, as well," Pan said. "So there is certainly a lot of movement going on."

Pan said the health committee wanted to make sure all of those transition programs had metrics in place ahead of time, so that success of those programs can be measured, he said, "with clearly defined outcomes, and sufficient evaluation tools in place."

Toby Douglas, director of DHCS, said the department is looking at a wide array of measurements -- from patient satisfaction surveys and beneficiary complaints to clinical outcomes. 

"When we talk about monitoring outcomes, it comes down to being able to have good data," Douglas said. "As we move to a managed care system, we will be more reliant on our managed care partners and counting on them to report up to us. So what we're working on now is, how do we ensure better accuracy, quality and data?"

A cornerstone of the monitoring effort is a project to develop a dashboard of metrics, so people can see quality measurements at a glance.

"We're working right now on development of the managed care dashboard, and it will be up and running before the CCI transition," Douglas said. "We want to take all of the different kinds of information from our health plans, compliance, financial, all of that, and we're rolling it all up into a scorecard, and this would fit into a dashboard, to allow us to measure over time the performance of our plans."

That was welcome news to committee member Das Williams (D-Santa Barbara).

"The idea that there will be actual numerical metrics is an exciting one to me," Williams said to Douglas. "So when would those be available?"

Douglas said the department would roll out the dashboard in "six to nine months." It will be a work in progress as new measurements are added over time, Douglas said.

"We want to have a picture medically, financially, we want beneficiary surveys," Douglas said. "So we can see, is this plan providing the best care at the best cost, or do we need to do something differently?"

Pan asked Douglas if the department would delay the launch of the duals project because the dashboard was not ready yet. Douglas said the dashboard would be done before the duals project launches.


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