Healthy Families and Other Transitions Examined by Assembly

The Assembly Health Committee held a hearing today on Managed Care Program Initiatives at the
Department of Health Care Services – or the transitions the department is overseeing: moving dual eligibles to managed care, moving seniors and people with disabilities to managed care, moving Healthy Families kids to MediCal, etc.

Consumer advocates and legislators have expressed concerns over how well these transitions are going.  Particularly, network adequacy and timely access rose to the surface as serious concerns for consumers who may be falling through the cracks in these transitions. Beth Capell of Health Access spoke of the importance of timely access, and that timely access is a good indicator that plans are financially solvent and that networks are adequate to provide care.

Toby Douglas, Director of the Department of Health Care Services and Shelly Rouillard, Chief Deputy Director of the Department of Managed Care presented information related to work that is being done to develop a dashboard of performance indicators to measure how well the transitions are going and made public commitments to look at best practices, adhere to public and legislative oversight, and to improve stakeholder involvement.  They also acknowledged the flaws in complaint driven oversight.

Currently, there is evidence that ongoing transitions are not progressing as smoothly as consumers deserve, and hint at the fact that the department and the health plans may not be adequately prepared to move forward with additional transitions.  However, there was concern about what was being done by way of enforcement or improvement as a result.  In his closing remarks, Committee Chair Richard Pan aptly noted that developing great performance indicators is just one step in the process – “once we get the results,” he said “we need to act on them.”

Hopefully, the interest of the Legislature evidenced by today’s and last week’s hearings will encourage more accountability and ensure that we can continue to provide crucial health care to our state’s most vulnerable.

Health Access California promotes quality, affordable health care for all Californians.
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