Recorded live July 23, 2020

Overview

Medi-Cal Managed Care financing is nothing short of complex. Tune in and learn how non-finance departments can support the rate development process, as well as how the State oversees plan finances.

Recording

Watch Webinar 3: Rate Development Support & State Oversight of Plan Finances

The password to access the recording can be found in your registrant recording notification email.

Materials

Webinar 3: Rate Development Support & State Oversight of Plan Finances
Download presentation materials

Please refer to your registrant reminder email for the password to access the materials.

Other LHPC Institute Resources:
Introduction to Medi-Cal Managed Care Financing Fact Sheet
Glossary of Health Care Terms and Acronyms

Agenda

Rate Development Support & State Oversight of Plan Finances

Agenda

• How non-finance departments can support the rate development process
• 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

Meredith Wurden
Consultant and Former Director, Policy and Fiscal Strategy for Partnership HealthPlan of California

Meredith Wurden most recently served as the 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.