The number of Californians enrolled in the Medi-Cal program and most beneficiaries enrolled in a managed care plan and historically low reimbursement rates makes Medi-Cal Managed Care a critical financial priority. Issues to address include access, care coordination, provider network sufficiency, claims processing and timely reimbursement.
To support member concerns the Hospital Council will:
Educate elected officials, legislative and regulatory staff, community leaders, and community groups about the financial challenges faced by hospitals and the impact on patient care in support of CHA on state and federal issues
Advocate locally for policies that support hospitals and health systems
Advocate for continued hospital control and decision-making about the use of hospital community benefit contributions and in support of CHA’s statewide efforts
Address operational improvement in rural Medi-Cal managed care counties in areas such as claims processing issues, denials and payment delays in conjunction with the team
Contingent on sufficient resolution of uncertainty in Washington, D.C. and with section and local stakeholder support, collaborating with local Medi-Cal managed care plans, hospitals, clinics, post-acute care providers, physician groups and other appropriate stakeholders to build on the recommendations from the 2016 Med-Cal Managed Care Task Force appropriate to each health plan service area
In 2016, the Medi-Cal Task Force: Promoting Accessibility and Sustainability of Medi-Cal in Local Communities, convened by Hospital Council of Northern and Central California and Hospital Association of Southern California (HASC), worked with the local Medi-Cal managed care health plans (Local Initiatives and County Organized Health Systems – COHS), community health centers, medical groups, county health systems and hospitals to identify best practices and remove barriers that prevent the delivery of coordinated, high quality, appropriate and efficient health care. The result of the efforts of the Task Force is a joint report with recommendations for action.
The current period of great change within health care is an opportunity to forge a future that brings diverse organizations together, acknowledges the strengths of all, and builds on those strengths. These recommendations can serve as an important guide to health system improvements.
In anticipation of local meetings with health plans, community health centers, physician groups and hospitals and other local stakeholders to address any of the recommendations in the final report of the Medi-Cal Task Force: Promoting Accessibility and Sustainability of Medi-Cal in Local Communities, the following resources have been collected to support local action.
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