LHPC Responds to DHCS Announcement of Medi-Cal Managed Care Contract Awards
SACRAMENTO, CA — On behalf of the Local Health Plans of California (LHPC), a group representing 16 of the not-for-profit local health plans that serve more than 70 percent of Californians enrolled in Medi-Cal managed care, CEO Linnea Koopmans offered comment following the Department of Health Care Services’ announcement of its intent to award Medi-Cal contracts to three managed care plans. Community Health Group, an LHPC local health plan member, was not included in the contract award despite having the largest Medi-Cal enrollment in the area (330,000 members) and their 40 years of experience delivering care to Medi-Cal and uninsured populations in San Diego County.
“It is disappointing to see that Community Health Group was not selected through Medi-Cal procurement given their track record for delivering excellent care with a community focus. As the only local plan choice in the region, this is a loss for San Diego.
“This is the first time in Medi-Cal’s history that a not-for-profit, local health plan, serving a small region with a community-focus, has not been selected through the contracting process. This leaves only commercial insurers to provide Medi-Cal coverage in San Diego County. Medi-Cal managed care began through local plans due to their ability to address the needs of their community while ensuring access to high quality health care.
“Community Health Group, which is the largest Medi-Cal plan in the region, epitomizes the unique community focus of a local health plan in Medi-Cal. The not-for-profit grew from a small health clinic as demand for their person-focused care grew throughout San Diego. In fact, more Medi-Cal enrollees in San Diego choose Community Health Group over the other commercial options in the area.
“Over the years, Community Health Group’s quality scores and performance have been consistently higher than all other Medi-Cal plans with a non-staff model in San Diego County and statewide. They have served Medi-Cal and the community well for the past 40 years.
“LHPC stands with our local plan partner as Community Health Group pursues all options to continue to ensure San Diegans have a local plan option.”
Local Health Plans of California (LHPC) is a statewide trade association that represents all 16 of the community-based, not-for-profit health plans that provide access to critical and comprehensive healthcare services for low-income populations enrolled in California’s Medicaid program, “Medi-Cal,” in 36 out of 58 counties in the state. With over 8.5 million enrollees, our plans serve approximately 70 percent of all Medi-Cal managed care beneficiaries. LHPC member plans cover more lives than 49 other states’ entire Medicaid programs. More here.