January 03, 2023
The California Section of Health Treatment Expert services (DHCS) has finalized an arrangement with 5 business managed treatment strategies to deliver Medi-Cal products and services in 21 counties across the point out starting off in January 2024. The options involve Blue Cross of California Partnership Plan (Anthem), Blue Shield of California Assure Health and fitness Prepare, CHG Foundation d.b.a. Community Overall health Team Partnership Strategy, Well being Net Group Solutions, Inc. and Molina Healthcare of California.
According to DHCS, these options, and all other Medi-Cal managed treatment prepare partners—including community options and Kaiser Permanente—will function less than a new, demanding agreement, to offer high quality, equitable and in depth protection for Medi-Cal managed treatment users. To support address the social motorists of wellness, the new contracts demand partnerships with regional health departments, community educational and governmental companies, and other local plans and expert services, like social companies, child welfare departments, and justice departments, to be certain member care is coordinated and associates have obtain to community-centered assets.
Managed Care Options
|Blue Cross of California Partnership Strategy (Anthem)||Alpine, Amador, Calaveras, El Dorado, Fresno, Inyo, Kern, Kings, Madera, Mono, Sacramento, San Francisco, Santa Clara, Tuolumne|
|Blue Shield of California Promise Health System||San Diego|
|CHG Foundation d.b.a. Neighborhood Health and fitness Team Partnership Strategy||San Diego|
|Health Internet Group Solutions, Inc.||Amador, Calaveras, Inyo, Los Angeles (with subcontract to Molina for 50% of membership), Mono, Sacramento, San Joaquin, Stanislaus, Tulare, Tuolumne|
|Molina Health care of California||Riverside, Sacramento, San Bernardino, San Diego, (and in Los Angeles subcontractor to Wellbeing Web for 50% of membership)|
*Daring implies a change from the earlier announced contracts in August 2022.
DHCS is also allowing 17 counties to adjust the sort of managed treatment design available, and authorised a proposed immediate deal with Kaiser Permanente in 32 counties, subject to federal approval.
In counties exactly where there are model and/or prepare modifications, medical professionals will need to have to take into account contracting with a new system if they would like to carry on to see Medi-Cal clients beginning in 2024.
The California Health care Association will be closely checking the changeover and will keep physicians knowledgeable as new info gets to be out there.
For extra information and facts, see the DHCS announcement.