Len Finocchio is a numbers guy, so he’s genuinely excited by a new set of survey data that paints a picture of recipients’ impressions of the Medi-Cal program.
“There is lots of data, lots of it,” said Finocchio, associate director of the Department of Health Care Services. “We will be continuing to mine it for a long time, to get insights about how to make the program better.”
Last week, the California HealthCare Foundation, which publishes California Healthline, released a survey of the attitudes and concerns of Medi-Cal beneficiaries. It has been a relatively long time since a similar survey was completed in 2000, so state health care officials were extremely pleased to get updated information, Finocchio said.
“We hear a lot from the Legislature, and we hear a lot from providers, from advocates and internally from our own data folks,” Finocchio said. “But this adds an important voice to that — the beneficiaries’ voice. This, to me, is a direct way of listening to what works for them, and what doesn’t work for them.”
For instance, he said, DHCS might be able to identify what people with three chronic illnesses might need in the program, or if people need more access to night and evening appointments. “We can’t answer every possible question,” he said, “but it’s a really useful tool.”
A new survey is being planned, he said — a joint effort between CHCF, the state and UC-Berkeley researchers — that will target a slightly different population — seniors and persons with disabilities who moved from fee-for-service to managed care. The target date for completion of the new survey is August, with results released sometime this fall.
One of the main general findings in the current survey is that beneficiaries are pretty happy with Medi-Cal. According to survey results, about 90% of the Medi-Cal insured have a positive view of the program and 78% said the program covers the care people need. That was good news for Finocchio and other state health officials.
“I am happy, and frankly a little proud,” Finocchio said, “that the program works as well as it does. Hearing so often about things that don’t work, we were surprised [by that]. So the goal for us next time, I guess, is to not be surprised.”
Chris Perrone, deputy director of CHCF’s Health Reform and Public Programs Initiative, said now’s a crucial time for health officials and stakeholders to know as much as possible about the challenges and successes of the Medi-Cal program.
“Medi-Cal is on the verge of profound changes,” Perrone said. “With the many budget issues, including new enrollee copayments, with the dual-eligibles project, the Healthy Families conversion, and with implementation of the Affordable Care Act, where we’re looking at 2 to 3 million more people on Medi-Cal, all of that is happening now.
“Medi-Cal is truly at a crossroads,” Perrone said. “So this is a good time to take a close look at it.”
One of the reasons for such a strongly positive survey response was that, by necessity, it excluded seniors, he said. That means many heavy users of the system, those with multiple chronic conditions and medications, were not polled in the current survey, because most of those recipients also receive Medicare coverage, and the survey focused on Medi-Cal coverage.
A few of those seniors will be contacted in the upcoming SPD study, though Perrone said 85% of those target subjects are under 65.
Finocchio said Medi-Cal has changed quite a bit since the last survey in 2000 — the number of beneficiaries has jumped from 5 to 7.5 million, and the number of optional benefits is substantially smaller. Those challenges are likely to increase, he said, as the state budget shrinks and more Californians are added to Medi-Cal.
“Our goal is to understand what’s done well and what’s done poorly, and to understand the subgroups of the Medi-Cal population,” Finocchio said. “But one good thing we did see is, government can work well. Given how challenging it is with our new budget, we are doing well. And we can do better.”
Finocchio hopes that another broad survey will be done in two years, as well.
“We’d like to see what trends there might be in beneficiaries’ feelings, so we have the consumers’ voice in order to make changes and improvements,” Finocchio said.
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