Report: Managed Care Transition Cumbersome for California Medicaid Seniors

California has completed a yearlong transition of moving 380,000 seniors and people with disabilities with Medicaid coverage from fee-for-service plans to managed care, but there were many speed bumps along the way, according to a report from the California HealthCare Foundation (pdf).

Advertisement

The Medi-Cal beneficiaries either voluntarily enrolled in managed care plans prior to this expansion, or the California Department of Health Care Services assigned a managed care provider to them. The California HealthCare Foundation conducted several interviews and surveys to analyze the effectiveness of the transition. Here are some of its findings:

•    Some beneficiaries had trouble understanding the complex written notices they received.

•    Providers that accepted new Medi-Cal seniors and disabled persons as patients said they did not receive patient-specific information in a timely fashion, and many of the managed care health plans had out-of-date contact information for several beneficiaries.

•    Some stakeholders said the managed care system “was not prepared” for the population, particularly in cases involving mental illness, homelessness and developmental disability.

More Articles on Dual Eligibles:

Massachusetts Becomes First State to Participate in CMS Dual Eligible Demonstration

Study: Medicaid Rolls to Expand by 14M People by 2019

CMS to Keep Enrollment for Dual-Eligibles Pilot Program Below 2M

At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.

Advertisement

Next Up in Financial Management

Advertisement

Comments are closed.