Medi-Cal Managed Care Program Questioned By Assemblyman Scott Wilk
Assemblyman Scott Wilk, R-Santa Clarita, attended Wednesday a Medi-Cal Managed Care Program Hearing.
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The hearing was intended to evaluate the effectiveness of the forced transition of former Healthy Families Program patients over to Medi-Cal Managed Care Program.
“The most troubling thing is that they eliminated the Healthy Families Program... which worked with a private and public partnership,” Wilk said. “But the budget forced the patients into the Medi-Cal Managed Care Plan, which made some of the patients have to leave their current doctors and go wherever they had to go.”
The purpose for the cancellation of Healthy Families Program was to save money long term, but Wilk said he believed the transition won't have the best outcome for patients.
The transition of patients to the Medi-Cal Managed Care Program will only cause more problems in the long run, Wilk said.
“They made the changes before I got to the Legislature,” Wilk said. “I would have most likely voted against the transition.”
The assemblyman said the hearing made him aware of program improvements that need to be made.
Medi-Cal Managed Care is meant to provide accessible and cost-effective health care “through managed care delivery systems,” according to California Department of Health Care Services.
The transaction was originally put in place to lower costs, but the increasing number of low income individuals needing assistance is a growing concern.
“The fact is, short-term it saves money, but long-term it doesn’t save money,” Wilk said.
If the number of persons needing assistance outweighs the number of providers for Medi-Cal patients, low-income and elderly patients will not get the proper coverage.
“Right now, we have incomplete data. My guess is that (the program) is not going very well,” Wilk said. “We couldn’t get a hold of a lot of people because it’s a difficult population to contact.”
The assemblyman noted that he is waiting for the next wave of data to determine whether the forced switch from Healthy Families Program to Medi-Cal was beneficial to the patients who were affected, but he is “not hopeful.”
The Oct. 23 hearing was a follow-up of an Oct. 2012 meeting to review plans for the transactions and discuss the experience of the changes with providers and enrollees.
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