One-third of California’s population now receives health care through Medi-Cal — nearly 13 million children, families, single adults, former foster youth, senior citizens, people with disabilities, and, starting this year, all eligible children regardless of their documentation status. We strive to help each beneficiary receive the right care at the right time in the right setting.
Our newly approved 1115 waiver, Medi-Cal 2020, appropriately sets out a vision for where the program and its providers are heading. The new waiver includes $6.2 billion of federal funding to support the Medi-Cal program and builds upon the successes of the state’s Bridge to Reform waiver in 2010, a critical piece of the state’s implementation of the Affordable Care Act. More than 4.2 million current Medi-Cal members have enrolled since California implemented the ACA in January 2014.
The Medi-Cal 2020 waiver will establish innovative changes in the way we and our providers deliver services to our beneficiaries, all with the goal of improving efficiency, access and quality of care. Medi-Cal 2020 also continues our initiatives for the Medi-Cal managed care program, Community-Based Adult Services, Coordinated Care Initiative (including Cal MediConnect), and our pioneering new model in substance use treatment, the Drug Medi-Cal Organized Delivery System.
The common thread among all these elements is a shift in thinking, from seeing care as a visit to a doctor when you’re feeling ill to building efficient, coordinated systems that meet people’s care needs, from prenatal care to the end of life.
The state is in the midst of transforming the health care delivery system in ways that were unheard of 50 years ago. It began in earnest in 2010 with the Bridge to Reform waiver, continued in 2014 with the implementation of the ACA, and continues today and in future years with Medi-Cal 2020 and our continued work to provide beneficiaries with quality, accessible care. We will likely continue to operate the fee-for-service delivery system for a small population of our beneficiaries, but managed care will be the primary vehicle by which millions of beneficiaries will receive their care.
We have successfully moved Medi-Cal from a paper-based, face-to-face system to an electronic, health plan-centric system in which members receive coordinated and specialized care in an organized delivery system. We will definitely see a change in how our members are able to manage their care electronically, utilizing applications and other programs to find a doctor, make appointments, see test results and rate their care.
Our work over the next five years will be to improve Medi-Cal and meet the challenges and opportunities that come with serving one-third of the state’s population, as well as ensure its success for the next 50 years.