CONSUMER ADVOCATE STATEMENT ON MEDI-CAL RECONTRACTING
Sacramento, CA – Two leading health and consumer advocate organizations have released the following statement in response to the recently announced Medi-Cal contract between the Department of Health Care Services (DHCS) and Kaiser Permanente.
“Health and consumer advocates have been strong supporters of the state’s proposal to recontract with all the managed care plans in our Medi-Cal program. It’s been decades since this re-contracting process has been done, and we have urged the state to hold all plans to higher standards for quality and equity for the over 14 million Californians who depend on Medi-Cal for their care. These standards should include Kaiser, which has avoided a statewide contract to date, and push them to do more in Medi-Cal.”
“The goals of this specific proposal is to provide patients from around the state continuity of care when moving from Kaiser plans to Medi-Cal, and for Kaiser to finally step up to provide more care in Medi-Cal, especially for vulnerable populations like foster children and “dual-eligible” seniors and people with disabilities. It’s a step in the right direction for the state to have greater and more direct oversight of Kaiser to ensure quality and equity on behalf of its 900,000 Medi-Cal patients, particularly in the 12 counties in which Kaiser is a subcontractor. While this proposal can help improve the capacity, quality, and accountability in the Medi-Cal program, we will be vigilant on Kaiser’s commitment to provide community supports and integrate with local safety-net services with input at the county level. As much as Kaiser does well on many quality metrics, it can and should do better. The arrangement between DHCS and Kaiser should include requirements to maintain or improve Kaiser’s record on quality and equity as they take on more of this vulnerable population, especially given their spotty record on behavioral health. This entire Medi-Cal recontracting process is an important effort to hold all health plans more accountable, Kaiser included.” says Anthony Wright, Executive Director of Health Access.
“Changes in health coverage due to life transitions can be incredibly destabilizing for consumers. We support the department’s efforts to ensure continuity of care for Kaiser members, allowing consumers to keep their doctor when joining Medi-Cal. At the same time, we urge the department to require Kaiser to do more in Medi-Cal, including further diversifying future enrollment. A direct contract has the potential to increase state oversight of Kaiser’s care of Medi-Cal members, an important step toward a more equitable program. In this arrangement, DHCS must rigorously enforce quality and equity standards and improvements for Kaiser, and must ensure that Kaiser is accountable both in their care of vulnerable Californians and in their partnerships with county safety-net services, including those that are instrumental to the success of CalAIM,” says Kiran Savage-Sangwan, Executive Director of the California Pan-Ethnic Health Network.