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Amid increasing state and national interest in using managed care delivery models for Medicaid beneficiaries, the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) hosted a public briefing on Tuesday, June 25, 2013 to provide information on recent transitions from fee-for-service to managed care, and to discuss their implications for care access and…
This brief examines how health service providers, plan administrators, and community-based organizations in Contra Costa, Kern, and Los Angeles Counties experienced the transition of Medi-Cal-only seniors and persons with disabilities (SPDs) to managed care as part of the state’s “Bridge to Reform” Medicaid waiver. Findings presented may inform similar transitions of high-need beneficiaries in other states and coverage expansions in 2014 under the Affordable Care Act.
This brief provides and update of the health care and health policy environment in California, discussing the budgetary environment, implementation of the state's "Bridge to Reform" Medicaid waiver, and efforts to prepare for coverage expansions and new coverage options in 2014 under the Affordable Care Act.
For Remaining Uninsured Residents, Cost and Immigration Status Are Main Obstacles Three years after the Affordable Care Act’s coverage expansions were fully implemented in California, nearly three quarters (72%) of the state’s previously uninsured residents now have health coverage, finds the fourth Kaiser Family Foundation Longitudinal Panel Survey, which is tracking the experiences of a randomly…
Building on an earlier brief that provided an overview of the components of DSRIP waivers, this analysis relied upon interviews with stakeholders to identify emerging trends and themes from DSRIP waivers in four states – California, Massachusetts, New York and Texas. It highlights that DSRIP waivers are spurring major change in relationships among providers; allowing providers to launch new initiatives aimed at improving care and reducing costs; and fostering a stronger focus on the social service needs of Medicaid beneficiaries. At the same time, the rapid pace of implementation is straining the ability of stakeholders to keep pace, including consumer advocates who are hard-pressed to track and respond to the DSRIP-driven changes that are fundamentally re-shaping the way that care is delivered to Medicaid beneficiaries.
California’s Medicaid program, Medi-Cal, is the largest state Medicaid program in the nation, insuring almost one-third of Californians. For several decades, Medi-Cal has been transitioning from a fee-for-service (FFS) system to risk-based managed care, and more than three-quarters of all Medi-Cal beneficiaries, including low-income children, adults, seniors, and people with disabilities, are now enrolled in managed care plans. As other state Medicaid programs increase their reliance on risk-based managed care, a review of California’s transition is both timely and illustrative. This issue brief provides an overview of the evolution of Medi-Cal managed care, key issues, and lessons for managed care programs in other states.
California is a bellwether state for understanding the impact of the Affordable Care Act (ACA). Much attention has been paid to enrollment in California's new coverage options, such as the Medicaid expansion (Medi-Cal) and plans sold through ACA marketplaces (Covered California), and to changes in the uninsured from 2013 to 2014. However, less is known about how this coverage has affected people’s access to care and financial security, and why others remain uninsured. This report, based on the 2014 Kaiser Survey of Low-Income Americans aims to fill this gap by comparing the newly insured, previously insured and remaining uninsured across several of these important dimensions.
This report is based on based on focus group discussions with parents with moderate incomes enrolled in private coverage (employer sponsored or Marketplace) who had children in public coverage (primarily CHIP) or children with private coverage. This report is based on 14 focus group discussions conducted by the Kaiser Family Foundation and John Snow, Inc. in six cities during February and March 2015. Sites included Birmingham, AL, Chicago, IL, Denver, CO, Philadelphia, PA, and Tampa, FL. Each of these states operate separate CHIP programs. An additional 4 focus groups were conducted in Los Angeles, CA (two in English and two in Spanish). The purpose of the groups was to gain insight into what low and middle-income families value in their children’s coverage, their experiences with CHIP and private insurance, and on parents’ perspectives on the future of CHIP. The information gathered can help inform policy questions such as would private coverage (either employer sponsored coverage or Marketplace) or Medicaid work for children who currently are enrolled in CHIP?
The Kaiser Family Foundation California Longitudinal Panel Survey is a series of surveys that, over time, tracks the experiences and views of a representative, randomly selected sample of Californians who were uninsured prior to the major coverage expansions under the Affordable Care Act (ACA). The initial baseline survey was conducted with a representative sample of 2,001 nonelderly uninsured Californian adults in summer 2013, prior to the ACA’s initial open enrollment period. The second survey in the series followed up with the same group of previously uninsured Californians who participated in the baseline (a longitudinal panel survey). The third in the series, and the focus of this report, followed up with them again after the second open enrollment period in spring 2015 to find out whether more have gained coverage, lost coverage, or remained uninsured, what barriers to coverage remain, how those who now have insurance view their coverage, and to assess the impacts that gaining health insurance may have had on financial security and access to care.
In the first of many events to highlight Affordable Care Act (ACA) implementation in the states and on the front lines across the country, the Kaiser Family Foundation partnered with the Blue Shield of California Foundation to examine ACA implementation in California (CA) at a Washington, D.C., briefing and panel discussion on February 19, 2014.
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