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Tip: Proactive scheduling strategies

January 03, 2023


The California Department of Health Care Services (DHCS) has finalized an agreement with five commercial managed care plans to deliver Medi-Cal services in 21 counties across the state starting in January 2024. The plans include Blue Cross of California Partnership Plan (Anthem), Blue Shield of California Promise Health Plan, CHG Foundation d.b.a. Community Health Group Partnership Plan, Health Net Community Solutions, Inc. and Molina Healthcare of California.

According to DHCS, these plans, and all other Medi-Cal managed care plan partners—including public plans and Kaiser Permanente—will operate under a new, rigorous contract, to provide quality, equitable and comprehensive coverage for Medi-Cal managed care members. To help address the social drivers of health, the new contracts require partnerships with local health departments, local educational and governmental agencies, and other local programs and services, including social services, child welfare departments, and justice departments, to ensure member care is coordinated and members have access to community-based resources. 

Managed Care Plans

Counties

Blue Cross of California Partnership Plan (Anthem) Alpine, Amador, Calaveras, El Dorado, Fresno, Inyo, Kern, Kings, Madera, Mono, Sacramento, San Francisco, Santa Clara, Tuolumne
Blue Shield of California Promise Health Plan San Diego
CHG Foundation d.b.a. Community Health Group Partnership Plan San Diego
Health Net Community Solutions, Inc. Amador, Calaveras, Inyo, Los Angeles (with subcontract to Molina for 50% of membership), Mono, Sacramento, San Joaquin, Stanislaus, Tulare, Tuolumne
Molina Healthcare of California Riverside, Sacramento, San Bernardino, San Diego, (and in Los Angeles subcontractor to Health Net for 50% of membership)

*Bold indicates a change from the previously announced contracts in August 2022.

DHCS is also allowing 17 counties to change the type of managed care model offered, and approved a proposed direct contract with Kaiser Permanente in 32 counties, subject to federal approval.

In counties where there are model and/or plan changes, physicians will need to consider contracting with a new plan if they wish to continue to see Medi-Cal patients beginning in 2024.

The California Medical Association will be closely monitoring the transition and will keep physicians informed as new information becomes available.

For more information, see the DHCS announcement.

 

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