Private Clinics Worried Over Ventura County’s Medi-Cal Restructuring
A network of private health clinics is expressing concern that Ventura County's plan to restructure its Medi-Cal system would divert patients and funds away from private health care providers and toward county-run facilities, the Ventura County Star reports.
Medi-Cal is California's Medicaid program.
California recently directed counties to modify the state-run Medi-Cal system into a locally administered managed care organization.
Ventura County's local Medi-Cal program -- called the Gold Coast Health Plan -- is scheduled to debut early next year. The new plan will:
- Assign Medi-Cal beneficiaries to a medical home;
- Negotiate reimbursement contracts with health care providers; and
- Set benefit levels.
More than 100,000 low-income Ventura County residents are expected to receive coverage through the Gold Coast Health Plan. The plan is expected to process up to $300 million in claims annually.
Concerns From Private Clinics
Leaders of a private clinic network called Clinicas del Camino Real say the 11-member commission tasked with reshaping the Medi-Cal program primarily consists of county-affiliated representatives.
They argue that the commission might structure the local Medi-Cal program in a way that favors county-run health programs at the expense of private clinics and hospitals.
Ventura County officials say the commission has fair representation from the public and private health care sector, as well as other constituencies.
They say their goal is to create a system that provides Medi-Cal beneficiaries with a choice in where they receive care and the option to remain with their current health care provider (Kisken, Ventura County Star, 9/26).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.