HWN Suggests

California’s Reboot of Troubled Medi-Cal Puts Pressure on Health Plans

Data shows that Medi-Cal plans are failing enrollees in many ways. Patients often have long waits or travel times for medical appointments, and get fragmented services and poor information about their care. Some communities of color, as well as rural residents, receive lower-quality service than others. To be fair, Medi-Cal has had its share of successes, too, including early and robust expansion of enrollment under the Affordable Care Act, extension of coverage to large numbers of immigrants without legal documents, and pioneering programs that address not only medical and mental health but also the social and environmental circumstances of enrollees.

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Featured

 Bold Changes Are in Store for Medi-Cal in 2024, but Will Patients Benefit?

California’s safety-net health program, Medi-Cal, is on the cusp of major changes that could rectify long-standing problems and improve health care for the state’s low-income population.

Articles of Interest

California’s Medi-Cal Expansion Is Lowering Poverty among Undocumented Immigrants

We estimate that the state-funded expansion of coverage to all undocumented immigrants could lower poverty among non-citizens by as much as 2.9 percentage points, equivalent to 125,000 people moved out of poverty (assuming that all income-eligible, uninsured undocumented residents enroll in Medi-Cal).

Children Now Insider: Medi-Cal 101

Medi-Cal (California’s version of Medicaid) is a free or low-cost program that provides health coverage to millions of Californians, including more than 5.3 million children in the state. In fact, Medi-Cal is one the big reasons why the rate of uninsured children in California has decreased from 20 percent in the late 1990’s to just 3 percent today.

Medi-Cal Managed Care: An Overview and Key Issues

California’s Medicaid program, Medi-Cal, is the largest state Medicaid program in the nation, insuring almost one-third of California’s more than 38 million residents. In the early 1970s, California was the first state to enter into risk contracts with managed care plans to serve some Medicaid beneficiaries, rather than pay for services on a fee-for-service (FFS) basis.

Medicaid and Health Equity: CalAIM’s Bold Experiment

CalAIM seeks to build upon the county-based Whole Person Care (WPC) and plan-based Health Homes Program (HHP) pilots to focus on social determinants of health to address the health needs of individuals experiencing homelessness, behavioral health care access, children with complex medical conditions, the growing number of justice-involved populations who have significant clinical needs, and seniors and individuals living with disabilities

The Medi-Cal Maze: Why Many Eligible Californians Don’t Enroll

Through virtual focus groups and in-depth interviews with 91 Californians, the research team explored the knowledge, attitudes, and enrollment experiences of people who are likely eligible for Medi-Cal yet remain uninsured.

Resources

California Advancing and Innovating Medi-Cal (CalAIM) Initiative

CalAIM is a long-term commitment to transform Medi-Cal, making the program more equitable, coordinated, and person-centered to help people maximize their health and life trajectory. The success of CalAIM will be a model for transformation of the entire health care sector.

Covered California

Medi-Cal is California’s Medicaid program that provides medical services to low-income people at little or no cost. It is administered by the Centers for Medicare and Medicaid Services (CMS) and the California Department of Health Care Services (DHCS).