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Oct 22, 2024 · Managed care plans are a cost-effective use of health care resources that improve health care access and assure quality of care. Today, approximately 15.2 million Medi-Cal members in all 58 counties receive their health care through five main models of managed care: Two-Plan, County Organized Health Systems (COHS), Geographic Managed Care (GMC), Regional Model (RM), and Single-Plan.
- Auto Assignment Incentive Program
The California Department of Health Care Services (DHCS) has...
- Medi-Cal Managed Care Quality Awards
On an annual basis, the California Department of Health Care...
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- Auto Assignment Incentive Program
Nov 8, 2024 · You can enroll in a Medi-Cal health plan by phone. Call Medi-Cal Health Care Options Monday– Friday, 8 a.m. to 6 p.m. at (800) 430-4263 (TTY: (800) 430-7077). Or enroll online at www.healthcareoptions.dhcs.ca.gov. For people with both Medicare and Medi-Cal, Medi-Medi Plans are available in certain counties for voluntary enrollment.
Starting in January 2024, all Medi-Cal plan partners statewide will operate under a new, rigorous managed care contract to provide quality, equitable, comprehensive coverage for Medi-Cal managed care members. This will transform and improve how care is delivered to millions of Californians in the Medi-Cal health system. 2.
Jan 16, 2024 · Medi-Cal rates are set by the state and must be certified by independent actuaries and reviewed and approved by the Centers for Medicare and Medicaid Services (CMS). Medi-Cal Managed Care plans must meet an 85% medical loss ratio (MLR) for their expansion populations. Medi-Cal Managed Care Health Plan Choices by County Managed Care is available ...
Managed Health Care (DMHC) licenses and regulates most Medi-Cal Managed Care plans. The State of California relies on Managed Care plans to provide comprehensive health coverage to 12.4 million Californians, or 4 out of 5 Medi-Cal enrollees. Consumers face no out-of-pocket costs, and most pay no monthly premiums.
Dec 22, 2023 · Starting Jan. 1, Medi-Cal, California’s Medicaid program, will implement new standardized contracts with its 22 managed care health plans, which collectively cover 99% of enrollees. The new contracts tighten enforcement of quality measures, especially for women and children; require the health plans to report publicly on the performance of medical providers ― and in some cases other ...
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Jan 25, 2023 · disenrolled to FFS Medi-Cal).9 In July, 2023, all managed care plans will also be required to cover Intermediate Care and Subacute Care Facility Services (previously these were also covered in COHS and Coordinated Care Initiative plans, but other managed care plans covered
