On Monday, Gov. Jerry Brown (D) appointed Jennifer Kent as the new director of the Department of Health Care Services, a $9 billion state agency that oversees the Medi-Cal program.
Kent had most recently been the executive director of Local Health Plans of California, an organization representing 14 not-for-profit public health plans across the state.
“I’m very excited,” Kent said. “It’s a big job, so I’m both thrilled and a little overwhelmed.”
Kent replaces Toby Douglas, who was DHCS director for the past four years. Kent has worked at DHCS in the past — in fact, she and Douglas were both deputy directors in the department at the same time. Kent worked at the department from 2004 to 2007. She headed legislative affairs for Gov. Arnold Schwarzenegger (R) and has experience in both the public and private spheres of health care.
Kent said she has big shoes to fill at the department and that the scope of change at the department has been unprecedented, topped by adding 2.7 million new enrollees to Medi-Cal and shifting more than 70% of beneficiaries into Medi-Cal managed care plans.
“I have watched the department lift the entire health care reform effort during a time of budget constraints, and set a national example,” Kent said. “So first and foremost, I recognize that people at the department accomplished quite a lot in a short amount of time.”
Now that the move to Medi-Cal managed care has been put in place, she said, there is a lot of work to do to make it successful.
“We have all put a lot of faith in the managed care system. Now we’re shifting from implementation to operation and function,” she said. “We are a managed care state in its entirety. … By and large we’ve chosen a delivery system, so now we all have to make managed care work so that it’s efficient and organized and accountable.”
The biggest obstacle to making it work, she said, is the sheer size of the Medi-Cal program, which currently covers more than 30% of the population of California — and 50% of its children.
“The magnitude of it,” Kent said. “It’s a big thing and it’s really complicated, with lots of moving pieces.” She said her familiarity with what the department has done and is doing should help smooth the transition.
“I’ve worked on the private side and the state side, so I have an appreciation for how the private sector thinks, and I also know how hard it is to move things on the government side,” Kent said. “There are some things needed by plans and providers, and one of them is certainty. … We need to be a good business partner, we owe it to them to provide consistent rules.”
One of the concerns raised in the state Legislature recently has been a need for greater monitoring of how Medi-Cal managed care is working, and whether quality and access are maintained.
“I do think the department has already done an extensive amount of that monitoring already. It’s been started,” Kent said. “It’s certainly the right question to be asking. This system we’ve chosen, is it doing what we expect it to do?”
Successful monitoring is based on good data, she said.
“It’s not an exciting cocktail conversation, but data is so important to monitor performance and reward quality,” she said. “You want to find the providers who are doing it right so you can point to them and say, ‘This is what we want to emulate.’ And you can’t do that without good data.”