Education Center

Overview

Education Center

Overview

Medi-Cal Managed Care 101

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.

Overview

LHPC Policy Issues

LHPC supports member plans’ mission of providing access to health care for California’s most vulnerable populations by:

Overview

Key Terms

Medi-Cal Fee-for-Service

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.

Overview

Facts & Resources

Learn more about how LHPC and our member plans’ are ensuring all Californians have access to affordable and quality health care services across the state.

Fact Sheets

Local Health Plans of California By the Numbers

A Snapshot of California’s ACA Optional Expansion

Overview

Publications

Commands