Session 1  |  March 13, 2023
Session 2  |  March 16, 2023
1:30 – 3:00 p.m., Pacific Time 

Registration is now closed.

Overview

How is the Medi-Cal program funded?
How does DHCS determine the rates it pays to managed care plans?

Medi-Cal managed care financing is nothing short of complex. Join us for this introductory webinar series and get answers to these questions and more. Expert faculty will discuss:

• Key concepts in federal and state financing of Medi-Cal and managed care
• How Medi-Cal managed care plans are paid
• Data used to develop rates
• Key components of the rate development process
• And more …

Who should participate:
Local health plan staff interested in learning the basics of Medi-Cal managed care financing. The series may be most valuable and informative for non-finance staff and staff who are new to managed care.

Session 1

Key Concepts in Medi-Cal Managed Care Financing &
Introduction to Rate Setting
March 13, 2023
1:30 – 3:00 p.m., Pacific Time 

Agenda

Key Concepts in Medi-Cal Managed Care Financing

• What is Medicaid and how is it funded?
• Medicaid funding in the COVID/post-COVID environment
• Medi-Cal enrollment trends
• How the Medi-Cal program is paid for
• Gubernatorial and legislative impact on managed care
• Factors that influence the California budget process
• Sources of Medi-Cal funding

Introduction to Rate Setting

• How Medi-Cal managed care plans are paid
• Risk — how it relates to Medi-Cal managed care rate setting
• Federal and state rate-setting requirements

Session 2

The Rate Development Process & State Oversight of Plan Finances
March 16, 2023
1:30 – 3:00 p.m., Pacific Time 

Agenda

The Rate Development Process

• What data is used for rate setting
• Key components of the rate development process
• New developments impacting rate setting — Enhanced Care Management & community supports, plan and model changes, regional rate setting
• Why rate setting matters — the importance of health plan data

State Oversight of Plan Finances

• DHCS and DMHC roles in financial oversight of managed care plans
• Key concepts in oversight — net income, tangible net equity, medical loss ratio, et. al
• What regulators look for in overseeing plan finances
• Plan reporting requirements

Faculty

Jennifer Lopez
Deputy Chief Financial Officer
Partnership HealthPlan of California

Jennifer Lopez is Partnership HealthPlan’s Deputy Chief Financial Officer and LHPC’s former Director of Health Plan Financing. She has a longstanding background in the public sector and the Medi-Cal program. During Jennifer’s time as Chief of the Capitated Rates Development Division at the California Department of Health Care Services, she acquired a deep knowledge base in Medi-Cal managed care financing and rate development. At the California Department of Finance, Jennifer played an instrumental role in major State Budget initiatives, developing public policy positions and advising administration officials on critical policy matters affecting millions of Californians.

Gil Riojas
Chief Financial Officer
Alameda Alliance for Health

Gil Riojas is Chief Financial Officer at Alameda Alliance for Health (Alliance), with responsibility for the overall financial management of the Alliance, including oversight of financial budgeting and forecasting, accounting, financial reporting and other related activities.

Prior to joining the Alliance, Gil worked for more than 15 years at the California Department of Managed Health Care (DMHC) where he oversaw the Financial Review Office and was responsible for monitoring the financial solvency and compliance of more than 124 managed care plans in California. Gil also served as an expert reporting to the Department’s Financial Solvency Standards Board and created the Department’s first comprehensive financial analysis report of Local Initiative and County Organized Health Plans.

Registration

NOTE: Health plan staff interested in participating should adhere to their respective plan’s process for LHPC Institute event registration where applicable.

Fees* (per connection)
Individual webinar                 $30
Full series                               $60
Plan series registration^       $160
*Special pricing is offered while health plan staff are working remotely. Standard pricing will resume when staff return to work on-site.
^ Select this option if plan staff will view the webinars communally on-site. Plans with multiple sites must register each site separately and identify whom at each site should receive the webinar access information upon registering. When registering, please enter unique email addresses for each additional site as the system may not allow duplicate logins.​​ Registration closes March 8.

Registration Confirmation: Registrants will receive two emails — a registration confirmation email and a separate email that contains access information for the webinar. 

Participating in the Webinar: You will only need a computer with an updated web browser (Google Chrome, Microsoft Edge, Mozilla Firefox or Safari are recommended). Participants may opt to listen to the webinar via telephone or device. 

Cancellation Policy: Cancellation notification must be submitted in writing to institute@lhpc.org seven or more days prior to the course date. Refunds will not be given after that date. Substitutions are encouraged. Payment will be due for registered individuals that do not attend or participate in the event, and for which a cancellation notice is not received.