Yesterday, DHCS hosted a webinar (agenda) on the expansion of Medi-Cal managed care into 28 Northern Rural counties. The Governor’s 2012-13 Budget initiated the expansion in the 28 fee-for-service counties and is set to begin June 2013. DHCS informed stakeholders that seven Northern Rural counties, including Del Norte, Humboldt, Lassen, Modoc, Shasta, Siskiyou, and Trinity, are excluded from the RFA since they will be participating in a County-Operated Health System (COHS) with Partnership HealthPlan of California (PHC). Stakeholders from these counties worked collaboratively with PHC and advocated heavily for a COHS model during the latter part of last year.
Lake, San Benito, and Imperial counties were also excluded from the RFA as they were included in the Governor’s 2005 expansion. Lake County will participate in the COHS model with PHC, while Imperial County will implement a two-plan model. Plan selections for this model have yet to be determined.
Anthem Blue Cross and California Health & Wellness Plan (Centene) were announced as plan providers for the remaining 18 contiguous counties. Centene is the the newest Medi-Cal managed care plan in California. They have operated in 730 rural counties throughout the U.S., serving 2.5 million Medicaid beneficiaries. Anthem Blue Cross is already a Healthy Families and CMSP partner, and plans to use a community-based model to build on county infrastructures.
DHCS will notify beneficiaries about the expansion with two notices. The notices for the eight COHS counties being served by PHC will be informational, introducing beneficiaries to PHC and the shift into managed care; beneficiaries in the 18 contiguous counties will receive a packet of information that asks them to select the plan they would like to participate in. Individuals who do not select a plan will be auto-assigned by a designated algorithm.
Since the webinar was cut short due to technical difficulties, DHCS plans to reschedule another stakeholder meeting within the next two weeks.
For more information on the expansion, visit the DHCS webpage here.
You may email questions, comments, and concerns to MMCD.TPGMC@dhcs.ca.gov