California’s reboot of troubled Medi-Cal puts pressure on health plans to perform

Denise Williams, of Adelanto, says the Inland Empire Health Plan, a county-run Medi-Cal managed-care insurer that covers her son, Markeano, does not coordinate effectively with his doctors or with another state agency that provides some of his care. “The state has had a lot of difficulty — because of skill and will — in managing and enforcing the terms of its existing contracts,” said Alex Briscoe, head of the California Children’s Trust and former director of Alameda County’s Health Care Services Agency. The report blamed the state’s poor performance on “deficient oversight of the managed care plans” and an insufficient number of healthcare providers willing to accept Medi-Cal’s low payment rates. “There aren’t enough teeth here to improve health plan accountability.” Other advocates cite what they say has been a cozy relationship between health plans and the state. I’ve got a kid that I need to take care of.’” Inland Empire Health acknowledged the gaps in coordination among managed-care plans, California Children’s Services and providers, saying it was “eager to embrace the care coordination improvements” that the state says it will require.