Senate Budget Subcommittee No. 3 Examines Managed Care Provider Network Adequacy

Today, Senator Richard Pan, on behalf of the Senate Budget Subcommittee No. 3 on Health and Human Services, held an oversight hearing to examine provider network adequacy in different managed care models in California. The hearing featured a presentation from Mari Cantwell, Chief Deputy Director of the Department of Health Care Services (DHCS), on the rate-setting process and the implementation of the managed care final rule.

Senator Pan then heard from three managed care plan officials representing the three different Medi-Cal managed care plan models – Inland Empire (Two-plan), Anthem Blue Cross/WellPoint (Regional), and the Central California Alliance (County Organized Health System). Discussions largely focused on plan model operations strategies, provider rate-setting processes, and the move toward value-based payments.

Provider and consumer organizations also shared their experiences with the Subcommittee and generally testified to the successes and challenges with managed care networks, managed care compliance and enforcement needs, and time and distance-related access to providers.

The hearing later concluded with limited public comments from patient advocates, dental hygienists, CalACEP and a couple other constituent groups.

The agenda and background materials can be found here.