Los Angeles Times Examines Criticism of HMO Molina Healthcare
The Los Angeles Times yesterday examined Long Beach-based Molina Healthcare -- one of the nation's largest and most profitable HMOs -- which some health care providers, consumer advocates and independent reviewers have said has increased profits at the expense of low-income members. Molina, whose profits increased to $30.5 million last year from $2.6 million in 1998, serves about 500,000 Medicaid beneficiaries in California and three other states. Molina officials attribute the company's financial success to its "providing medical care efficiently and to its long experience serving culturally diverse communities," but critics maintain that the HMO has increased profits "partly because its members don't see doctors when they should and may not complain when they are denied care," the Times reports. In addition, Molina often shifts the cost of care of low-income children with acute illnesses to state programs, and the HMO has childhood immunization rates below the state average, according to reports from the state and a health care analyst. Many HMOs make "handsome returns" from contracts with state Medicaid programs, but critics maintain that "hefty profit margins are incongruous at a time when regional HMOs have generally struggled" and states have made reductions to their Medicaid programs, the Times reports.
However, many patients and others said that Molina provides a large network of physicians, sends appointment and immunization reminders to patients and does not delay authorization for medical services and procedures (Vrana, Los Angeles Times, 5/4). Julie Olson, a director in the Utah Department of Health, said, "Molina has done a good job for us. They are very good at looking at what is the most cost-effective solution for the patient to get care" (AP/San Francisco Chronicle, 5/4). Lea Brooks, a spokesperson for the Department of Health Services, added, "Molina is meeting its contractual obligations and is particularly strong in serving minority populations." Molina officials did not comment (Los Angeles Times, 5/4).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.