By OPEN MINDS Circle
On August 25, 2022, the California Department of Health Care Services’ (DHCS) issued a news release announcing its intent to award contracts for its Medi-Cal (California’s Medicaid program) managed care plan (MCP) contracts. The organizations announced include Molina Healthcare, Anthem Blue Cross Partnership Plan, and Health Net. The selected MCOs will go through a readiness review period from October 2022 through December 31, 2023. The plans will go live on January 1, 2024, and run through December 31, 2028. Prior to this solicitation, each state county was responsible for its own procurement process.
The procurement affects three million of the state’s over 11 million Medicaid beneficiaries as of January 31, 2022. A key focus in the new contracts is advancing health equity and improving population health. This new NCQA program is focused on advancing the delivery of more equitable and culturally and linguistically appropriate services across member populations. The chosen MCPs will serve the following counties in the state:
|
Medi-Cal MCPs & The California Counties They Will Serve | |
| Intended Awardees |
Counties |
| Molina Healthcare | Los Angeles, Riverside, San Bernardino, Sacramento, San Diego |
| Anthem Blue Cross Partnership Plan | Alpine, Amador, Calaveras, El Dorado, Fresno, Inyo, Kern, Kings, Madera, Mono, Santa Clara, San Francisco, Sacramento, Tuolumne |
| Health Net | Amador, Calaveras, Inyo, Mono, San Diego, San Joaquin, Stanislaus, Tulare, Tuolumne |
MCP partners will engage with local entities to promote member needs for both medically necessary health care services, and any supportive services needed to treat the whole person. These partnerships will be with local health departments, local educational and governmental agencies, and other local programs and services, including social services, child welfare departments, and justice departments. The goal of these partnerships is to ensure member care is coordinated and members have access to community-based resources, including Community Supports available through California Advancing and Innovating CalAIM. The MCO plans and their subcontracted health plans areb required to achieve the new Health Equity Accreditation from the National Committee for Quality Assurance (NCQA).
DHCS is also strengthening its oversight of MCP partners. DHCS’ payments to plans are now linked more closely to the value they provide in terms of member access and outcomes. This will give plans incentives to provide care in a way that is aimed at improving health and well-being rather than just providing services. Moreover, the contract will help reduce disparities in care and improve health outcomes, while enhancing transparency so Medi-Cal members can find the plan that best suits their needs.
Prior For more information, contact:
- Michelle Baass, Director, California Department of Health Care Services, 1501 Capitol Avenue, MS 0000, Post Office Box 997413, Sacramento, California 95899; Email: dhcspress@dhcs.ca.gov; Website: https://www.dhcs.ca.gov/
- Caroline Zubieta, Director of Public Relations, Molina Healthcare, Inc., 200 Oceangate, Suite 100, Long Beach, California 90802; 562-951-1588; Email: Caroline.Zubieta@molinahealthcare.com; Website: https://www.molinahealthcare.com/
- Leslie Porras, Senior Director, Public Relations, Anthem, Inc., 220 Virginia Avenue, Indianapolis, Indiana 46204; Email: leslie.porras@anthem.com; Website: https://www.antheminc.com/
- Darrel Ng, Vice President, Communications and Marketing, Health Net, 21281 Burbank Boulevard, Woodland Hills, California, 91367-7073; Website: https://www.healthnet.com/