Two UC Medical Centers Dropping Medi-Cal Managed Care Contract

Health Net and two University of California medical centers agreed to sever ties on a Medi-Cal managed care contract. As of Jan. 1, that means roughly 4,300 patients will need to find new providers.

According to Health Net, letters announcing the change have been mailed to patients and they should be receiving the notices now.

The negated contract affects about 3,700 patients in Sacramento County and an additional 600 in San Diego County, according to Health Net officials.

On Friday, a group of residents and medical students at UC-Davis plans to submit a petition calling for reversal of the decision.

“What I’m worried about is, many of our patients have chronic conditions, and multiple chronic conditions, and I’m concerned about them suddenly not getting care,” said Alinea Noronha, a medical resident at UC-Davis who helped organize the petition effort.

“Many of these people are not going to have a doctor at the end of the month,” Noronha said. “And that’s a problem.”

Health Net officials said the 3,700 Medi-Cal managed care patients at UC-Davis will be shifted to River City Medical Group.

“We are working closely on the transition with River City Medical Group and our members,” said Brad Kieffer, director of communications at Health Net. “We understand a transition like this can be disruptive, and anytime there’s a transition from one medical group to another, our aim is to make that transition as smooth as possible.”

Those 3,700 people represent a little more than 3% of Health Net’s 109,000 covered people in Sacramento County, Kieffer said. The 600 at UC-San Diego represent about 1% of the 53,000 people covered in San Diego County, he said. Kieffer said Health Net doesn’t often have to switch so many people to new provider groups.

“It’s not common,” Kieffer said. “It does happen from time to time. At the end of the day, it’s the Medi-Cal insurance providers’ responsibility to make sure everyone has access to quality care.”

Phyllis Brown, senior public information officer at UC-Davis, said the decision has been made to discontinue the Health Net geographic managed care (GMC) contract.

“It’s my understanding that this is no longer under negotiation,” Brown said. “We were willing to see these patients, but we were unable to come to an agreement to revise the contract. This has been ongoing for some time.”

The medical center in Sacramento still is a safety-net facility, Brown said.

“About 35% of our patient volume is Medi-Cal,” she said. “So this is a small subset of that.”

Noronha’s concern is not only that there will be no warm handoff to a new provider group, but also that this loss of Medi-Cal managed care patients means something to the identity of the teaching hospital.

“I don’t think they thought through what it meant to lose this contract,” she said. “This is more than just a fiscal decision, it’s a patient decision.”

Access for Medi-Cal patients already is an issue in Sacramento County, Noronha said, and that can’t be helped by removing UC-Davis from this Medi-Cal managed care equation.

“Putting these people in a market that’s already saturated,” Noronha said, “it just doesn’t seem right. It doesn’t seem like it’s the kind of thing you’d do to your mother.”

Related Topics

Capitol Desk Medi-Cal