Medi-Cal Managed Care Studies – Regional Model and Geographic Managed Care
Last week, the California Health Care Foundation released two new studies by the Blue Sky Consulting Group assessing quality of care, access, and the provider’s experience under two models of Medi-Cal managed care, the Regional and Geographic Managed Care (GMC) models.
The Regional paper concludes that Medi-Cal enrollees in Regional model counties have received somewhat poorer quality of care, have greater difficulty accessing specialty care, and are less satisfied with their health care compared to Medi-Cal enrollees living in other rural counties. However, access to primary care was somewhat better in Regional model counties compared to other rural counties, and overall quality was improving at a faster rate in Regional model counties.
A key research question for the GMC analysis was: Do multiple managed care plan choices for Medi-Cal enrollees result in better outcomes? The paper concludes that the added competition does not result in better quality, access, or patient satisfaction in GMC counties when compared to similar urban counties with different models of Medi-Cal managed care. Meanwhile, the multiplicity of plans creates a confusing patchwork of networks, providers, benefits, and services that often confuse enrollees and present many redundancies for providers.
Both papers provide recommendations to state policymakers and program officials for improving care for Medi-Cal enrollees served by these managed care models.