Local health care delivery key to Kaiser Medi-Cal contract
In a recent op-ed, Jarrod McNaughton of the Inland Empire Health Plan (IEHP) – a valued Kaiser Permanente local partner – repeats prior criticisms of the Department of Health Care Services’ (DHCS) proposed single, direct contract with Kaiser Permanente for Medi-Cal services.
We have had strong relationships with local partners for 30 years, and we want that to continue, and grow even stronger. We understand some have concerns, but the state’s proposal – discussed in multiple public legislative hearings – addresses those concerns.
This contract doesn’t allow unfair or unfettered competition against local plans.
The state contract is about expanding access and quality in Medi-Cal. Kaiser Permanente provides the highest quality Medi-Cal coverage and care in the state.
Currently, Kaiser Permanente subcontracts across parts of the state to provide Medi-Cal coverage. We are required to pay upwards of $200 million in administrative fees. This state contract allows us to put that money instead into more and better care for Medi-Cal members and the into communities that we serve.
Critics claim this will allow Kaiser Permanente to compete unfairly, cutting local plans’ membership. They also claim we will cherry pick only the healthiest members. Neither claim is true.
We don’t cherry pick: The health conditions and demographic mix of our Medi-Cal membership are comparable to other Medi-Cal managed care plans, as measured by DHCS. That won’t change under this agreement.
This contract doesn’t allow unfair or unfettered competition against local plans. The agreement requires that where we have commercial members, we will provide Medi-Cal as well, with safeguards.
Our Medi-Cal services are based on continuity of care, which lets a single mother move between employer-paid coverage, Covered California, and Medi-Cal without losing coverage nor access to physicians. This state contract allows more people like her in other areas we serve to enjoy similar, seamless access to the care they need.
It will also allow us to do the same for foster children and for seniors who are dually enrolled in Medicare and Medi-Cal.
We’re excited about bringing our high-quality care to more Medi-Cal patients and working with local plans and safety net partners to help improve quality across the state, through this new state contract.
Editor’s Note: Arif Shaikh is the director of Medi-Cal and state-sponsored programs for Kaiser Permanente.
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