A close look at Medi-Cal managed care: quality, access, and the provider's experience under geographic managed care
- Collection:
- Health Policy and Services Research
- Author(s):
- Finocchio, Len, author Newman, Matthew, author Blosser, Shawn, author
- Contributor(s):
- California HealthCare Foundation, issuing body.
- Publication:
- [Oakland, California] : California Health Care Foundation, October 2019
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Managed Care Programs -- organization & administration Medicaid -- organization & administration Health Personnel Health Services Accessibility Local Government Quality of Health Care State Government Humans California United States
- Genre(s):
- Technical Report
- Abstract:
- In most counties in California, the Department of Health Care Services (DHCS) contracts with one or two managed care plans (MCPs) to deliver services to Medi-Cal enrollees. In just two counties, Sacramento and San Diego, DHCS contracts directly with five or more MCPs. This approach, the Geographic Managed Care (GMC) model, provides enrollees in those counties with more options. It is unclear whether greater competition among MCPs has led to higher quality of care, better access to services, or better experiences for Medi-Cal enrollees and their providers, or whether market fragmentation leads to navigational challenges and poor coordination of care. In 2020, DHCS is scheduled to release its Request for Proposals (RFPs) to begin the procurement process to select commercial MCPs for the Medi-Cal program starting in January 2023. This makes it the ideal time to assess the GMC model of managed care and whether, and under what circumstances, DHCS should continue to support it. Using a mixed-methods approach that combines quantitative and qualitative analysis, this report examines how quality of care, access to care, and patient satisfaction in GMC counties compare with similar urban counties that use a County Organized Health System (or COHS, a single public MCP) or the Two-Plan model (where a public MCP and a commercial MCP compete).
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)
- Extent:
- 1 online resource (1 PDF file (34 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101758770 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101758770