Proposed Medi-Cal changes questioned

February 24, 2012

Major changes for the state’s medical program for the needy are in the works, even as legislative advisers and advocates raise major questions. [CaliforniaWatch]

Changes include more seniors being routed to managed care programs, a reinvention of how hospitals are paid and the collapse of two state agencies that currently serve beneficiaries, California Watch said.

The Legislative Analyst’s Office prepared a written statement on Friday warning constituents and legislators alike to vote down Gov. Jerry Brown’s new plans for the Medi-Cal and Medicare programs.

The Governor’s changes would supposedly save some $679 billion during this year alone by redefining the hospital billing system, putting more seniors into the hands of managed care, and allowing the Department of Health Care Services to absorb the duties of the state’s mental health facilities as well as drug and alcohol programs.

The plan is based on a pilot project launched in four counties within the state that moved current Medi-Cal and Medicare patients into managed care. Upon implementation within the entire state, some 1.9 million Medicare and Medi-Cal patients, including those with disabilities, would be affected by the changes.

While the pilot seemed successful where implemented, the analyst’s office called the proposal to implement such policies statewide “premature” and encouraged further assessments and evidence of the program’s success before proceeding with the plan in other areas.

The Senate and Assembly will hold a joint hearing today to discuss the transition from the old to new ways in which hospitals are paid. Legislation passed in 2010 calls for a change from the status quo, where hospitals are being paid by prearranged rates, to a new form of payment based on how sick patients are. The switch is scheduled to take place Jan. 1, 2013