Event

Medi-Cal Managed Care Finance 101 Webinar Series
Foundational concepts and principles of managed care financing

Session 1  |  April 12, 2021
Session 2  |  April 13, 2021

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?
How does the State oversee plan finances?

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
  • Rate development process
  • Considerations for ensuring reasonable payment
  • Regulatory oversight of plan finances
  • 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 finance.

Session 1

Key Concepts in Federal & State Financing of Medi-Cal &
Managed Care
April 12, 2021
1:30 – 3:00 p.m., Pacific Time 

Agenda

  • What is Medicaid and how is it funded?
  • 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
  • Medi-Cal funding in the COVID/post-COVID environment

Session 2

The Rate Development Process & State Oversight of Plan Finances
April 13, 2021
1:30 – 3:00 p.m., Pacific Time 

Agenda

  • Key components of the rate development process
  • What data is used for rate setting
  • Tools impacting plan payment — base data, efficiency and risk adjustments and more
  • Considerations for ensuring reasonable payment
  • Challenges in and proposals to improve Medi-Cal rate setting
  • 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

Jonathan Freedman
Vice President
Health Management Associates


Jonathan Freedman works with plans, providers, associations, and governmental and non-governmental entities in the areas of public health, safety net health care, and public policy. His work focuses on strategic planning, public health improvement and transformation, and the health care safety net. Prior to joining HMA, Mr. Freedman held a variety of management and leadership roles at L.A. Care Health Plan and with the County of Los Angeles, and led a number of high-profile health- and health care-related initiatives.

Meredith Wurden
Associate Director
Sellers Dorsey


Meredith Wurden is an Associate Director with Sellers Dorsey. She previously served as Director of Policy and Fiscal Strategy at Partnership HealthPlan of California (PHC) where she was responsible for fiscal policy development and communication. Prior to PHC, Meredith worked for the state of California for nearly ten years. She also previously served as Assistant Deputy Director of Health Care Financing at the California Department of Health Care Services and with the California State Legislature covering health issues, including as a principal fiscal and policy analyst for the non-partisan California Legislative Analyst’s Office and as Deputy Director at the California Senate Office of Research. Meredith also worked at the federal Government Accountability Office.

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 organization. This includes 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 where he oversaw the Financial Review Office and was responsible for monitoring the financial solvency and compliance of more than 124 managed care plans statewide.

Registration

Registration is now closed.

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 Confirmation: Registrants will receive an email notification confirming their registration.

Participating in the Webinar: You will only need a computer with a web browser (Google Chrome, Microsoft Edge or Mozilla Firefox is recommended; Internet Explorer may not be supported) and a telephone. Audio for the program will be available via toll-free number or by using your computer speakers. 

Cancellation and No-Show 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 the event and for which a cancellation notice is not received.