Public Hospitals To Discuss Plan To Increase Enrollment in Medi-Cal Managed Care Plans
The California Association of Public Hospitals at its annual meeting this week will discuss the effects that shifting Medi-Cal beneficiaries to managed care plans could have on the 15 public hospitals in California, the Santa Rosa Press Democrat reports.
The administration of Gov. Arnold Schwarzenegger (R) earlier this year proposed redesigning Medi-Cal for beneficiaries in 13 counties, including Sonoma, Marin, Napa and Lake counties. The plan would establish managed care systems for beneficiaries that would give them access to a primary care physician, as well as a network of hospitals, clinics and doctors that contract with the health plan.
About 22 counties in California currently have Medi-Cal managed care plans.
Public hospitals, which receive about 50% of their funding from Medi-Cal, are concerned that Medi-Cal managed care plans would not contract with them for services and would send patients to other hospitals.
Health and Human Services Agency spokesperson Nicole Kasabian Evans said an HMO system could encourage more doctors and specialists to participate in Medi-Cal.
Some community clinics and private hospitals also believe a managed care system would reduce health costs and visits to emergency departments (Benfell, Santa Rosa Press Democrat, 12/5).