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With so many changes in Medi-Cal services and reimbursement rates, the state has been working on a system to constantly update and alert physicians, nurses and other providers about the latest wrinkles in Medi-Cal administration.
“We’ve never offered this before,” said Dan Nand, web content lead at Xerox State Healthcare, which is working with the state Department of Health Care Services on the updating project. “Providers have never had a chance to do this before. Now they’ll be able to read all of the announcements by desktop, or by mobile phones.”
The idea is to have a series of networks, like an advanced kind of listserv system, Nand said, in which providers can sign up for specific specialty areas, such as acupuncture or long-term care.
Safety-Net Hospitals Face Funding Cuts on Two Federal Fronts
Safety-net hospitals are facing a double-whammy of funding cuts: The Affordable Care Act lowers Medicaid payments to hospitals for uncompensated care and changes in Medicare reimbursements could mean further reductions in payments to safety-net hospitals.
Access, Clinic Finances, ED Overuse All Major Concerns for CMA
With health care reform and the state’s cutbacks and reorganization of its health care system, the practice of medicine in California is about to undergo major changes. California Medical Association officials have serious concerns about some of those changes.
“Yes, we are in a budget crunch, and yes, money is tight,” said Doug Brosnan, an emergency department physician and a member of the CMA’s board of trustees. “But there is suffering. Patients are suffering because they lack access to basic services.”
Brosnan was part of a group of CMA officials who met with reporters on Friday in Sacramento to talk about California’s recent spate of budget cuts to health programs and the outlook for reform after the Supreme Court’s decision to uphold most of the Affordable Care Act. CMA officials said they are concerned about the state’s efforts to reorganize existing services — such as the duals demonstration project, or the shift of 873,000 children from the Healthy Families program to Medi-Cal managed care.
Timeline Delineates Duals Project Tasks
The state Department of Health Care Services has released a timeline of deadlines and target dates for its Coordinated Care Initiative, also known as the duals demonstration project.
Eventually, the duals project hopes to move about one million Californians dually eligible for Medi-Cal and Medicare benefits into Medi-Cal managed care plans. The idea, state officials have said, is to provide better, more integrated care by pooling the funding sources from two disparate programs. Coordinated care could provide stronger case management, offer needed services and save state and federal dollars.
The pilot program in eight counties, beginning in March, 2013, will serve about 700,000 of the state’s dual eligibles.
How Much Will States’ Medicaid Expansions Really Cost?
State officials are wrestling with whether to join the Affordable Care Act’s Medicaid expansion, but as part of their evaluation process, many are relying on cost estimates that are not accurate.
Rural Clinics Hope DHCS Email Will Turn Tide in Medi-Cal Benefits Lawsuit
The Department of Health Care Services has been accused of withholding information in a court case — information that has the potential to change the reimbursement status of rural health centers and federally qualified health centers in California, according to court documents filed Monday in the U.S. Court of Appeals Ninth Circuit by the California Association of Rural Health Clinics.
Officials from DHCS could not comment on the lawsuit, according to Norman Williams, deputy director of public affairs for DHCS.
“As this matter is in active litigation, DHCS will provide its response to CARHC’s recent motion in an upcoming court filing,” Williams said.
The Medicaid Mess: Where Do States Stand on ObamaCare Expansion?
State leaders are wrestling with whether to take part in the Affordable Care Act’s newly voluntary Medicaid expansion. Several policy and political concerns are driving their decisions.
Copay Proposal for Some Drugs, Emergency Visits
The Senate Committee on Budget and Fiscal Review last week approved a significantly scaled-down version of a copay proposal for Medi-Cal beneficiaries.
The Legislature last year passed a more extensive copay proposal that was projected to save $511 million in general fund dollars for the state. It called for $5 per physician visit and $50 for an emergency department visit . In February federal health care officials nixed that plan.
The current proposal would impose a copay of $3.10 for non-preferred drugs, with an exception for patients who receive those medications by mail, and a $15 copay for non-emergency use of the emergency room.
State Health Officials Intrigued by New Medi-Cal Data
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.
Duals Project Goes to CMS for Approval
It was a big moment for officials in the Department of Health Care Services.
“We are thrilled to be getting this in,” said Jane Ogle, deputy director of DHCS. “It’s a big project. So to get this in, we’re all really excited. This is the result of a year’s planning, a year of planning and work with advocates and stakeholders and within the department. And all of that comes together in this document.”
The project is the Coordinated Care Initiative, also known as the duals demonstration project, and the document is the project’s final plan, which was submitted late last week to CMS.