Rural Medi-Cal Managed Care Effort Begins

by David Gorn

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Californians in 28 rural counties now have access to Medi-Cal managed care plans, bringing state-linked managed care plans to all 58 California counties. The expansion will affect roughly 274,000 residents in rural areas, according to Toby Douglas, director of the Department of Health Care Services, which is coordinating the effort.

"Managed care increases patient satisfaction and delivers higher quality care and more positive health outcomes," Douglas said in a written statement.

State officials hope managed care will reduce costs and improve quality of care and access to services.

Californians in the 28 rural counties had received Medi-Cal services in a fee-for-service model. On Sept. 1, DHCS expanded Medi-Cal managed care to eight far-north California counties. On Nov. 1, managed care expanded to the other 20 rural counties.    

So far, according to Assembly member Wesley Chesbro (D-Arcata), the transition has gone pretty well, in that providers in rural areas have appreciated their interaction with DHCS during the set-up of Medi-Cal managed care.

Chesbro complimented Douglas and the department's work publicly at an Assembly oversight hearing last week.

"I know the department -- and you -- are most accustomed to me complaining and pushing," Chesbro said. "And so I wanted to say something positive, with regard to rural issues. The department has been responsive, and I just wanted to express my appreciation for that. There has been some real responsiveness to rural providers in rural communities, so thanks."

The state wanted to establish managed care programs in all California counties before the Medi-Cal expansion begins Jan. 1, 2014 -- when the state plans to enroll roughly one million newly eligible Medi-Cal beneficiaries. Federal money will fully fund the expansion for the first three years, and then  decline slightly to 90% of the expansion by 2020.

"This is an important day for California as we continue our march to expand coverage and benefits to more Californians in need," Douglas said in his written statement.


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