Medi-Cal (California’s Medicaid program) is the largest payer for health care services in the State, covering one-third, or 14 million, of the State’s residents. Of that number, nearly 80% (10.6 million) of Medi-Cal beneficiaries receive their care through a managed care delivery system. The California Department of Health Care Services (DHCS) is California’s Medicaid Agency.
LHPC, in conjunction with the LHPC Institute, offers a number of core courses and topical programs that have been developed to help members understand the purpose, mission and operations of local health plans.
Program offerings cover a range of topics for staff at all levels and across various departments. Whether you are new to the local health plan model or well-versed in its operations, we are sure to have a program that will bolster your knowledge and provide you with the tools and information you need to be successful.
Under fee-for-service Medi-Cal, beneficiaries are responsible for finding primary care providers and specialists who are willing to accept Medi-Cal; beneficiaries are not matched with a primary care provider who coordinates their care. The California Department of Health Care Services (DHCS) establishes fee schedules, negotiates rates with hospitals, determines medical necessity criteria and pays provider claims for services provided.