SONOMA COUNTY: To Establish Medi-Cal HMO
Sonoma County wants to convert its "modified managed care program for Medi-Cal recipients" into a "full-blown HMO," the Santa Rosa Press Democrat reports. The Sonoma County "Board of Supervisors today will be asked to approve the first steps in building an independent" HMO to care for the county's 44,000 Medi-Cal enrollees. Sonoma County Public Health Director Mark Kostielney said, "This is very consistent with what this county has considered part of its job -- creating a safety net network for the poorest people in our community." County supervisor Tim Smith said, "I think there are a couple of fundamental questions about who assumes the risk and for how long, but generally the plan seems in keeping with the long history this board has of trying to be ahead of the game with changes in human services."
If the board approves the action, the county could eventually receive "as much as $1 million in seed money from state and federal health budgets" under a bill (HR 3104) being sponsored by state Rep. George Radanovich (R-Fresno). The bill would allow four counties in the state, including Sonoma, to "develop county- organized HMOs." Currently, Sonoma has about 20,000 Medi-Cal beneficiaries in a three-year pilot program that requires them to select a primary care provider to coordinate their care. "Sonoma County's Medi-Cal program is based on traditional fee-for- services payment to doctors and hospitals," but the new HMO would move the reimbursement system to a capitated schedule (Lauer, 2/10).