California Dreaming: A New Dawn for Medi-Cal
Health Tech 4 Medicaid
We're on a mission to radically change the pace of innovation in Medicaid, improving quality, equity and access to care.
California is undergoing transformative changes in its Medi-Cal program, promising improved health care for its most vulnerable populations—including youth, those with immigrant status, disabled individuals, older adults, and the justice-involved. With major reforms and innovations on the horizon, now is an exhilarating time to dream about a more equitable and effective health care system in the Golden State.
A Revolution in Eligibility & Coverage
As of January 1, 2024, California abolished the asset limit for Medi-Cal eligibility. This pivotal change meant that many more Californians—particularly the elderly, disabled, and those in long-term care—will no longer need to deplete their savings to qualify for health coverage. By removing these financial barriers, California is setting a precedent for a more inclusive and compassionate health care system. This shift will ease the bureaucratic burden on thousands, making health care access simpler and more humane.?
Contractual Reforms to Elevate Care
Medi-Cal's new era isn't just about expanding eligibility; it's about enhancing the quality of care. The upcoming standardized contracts with Medi-Cal’s 22 managed care plans, which cover nearly all enrollees, are tightening the reins on quality measures. These contracts are designed to ensure that health plans are held accountable for their performance, particularly regarding the care of women and children. They also mandate a greater integration of physical and mental health services, crucial for holistic health care. The contracts require plans to publicize provider performance and to invest more in closing the gaps in primary care access. This transparency is not just administrative—it's a commitment to ensuring that every Medi-Cal member receives high-quality, comprehensive health care tailored to their cultural and linguistic needs, and sensitive to their sexual orientation and gender identity.
Groundbreaking Financial Reinvestment
For the first time, these contracts also compel health plans to reinvest a portion of their profits—between 5% and 7.5%—back into the communities they serve. This initiative aims to foster community health and wellbeing, ensuring that profits are used to improve the very services beneficiaries rely on. In cases where plans fail to meet quality and health equity benchmarks, they must reinvest an additional 7.5% of their profits. This powerful incentive is designed to boost performance and directly benefit Medi-Cal members.
Embracing Technology & Innovation
The integration of Health IT and AI into Medi-Cal is a game-changer. These technologies are not just modernizing administrative tasks—they are enhancing predictive analytics, improving diagnosis accuracy, and personalizing patient care. As these tools become more embedded in Medi-Cal's operations, they promise to make health care more efficient and effective, particularly in managing chronic diseases and allocating resources where they are most needed.
Challenges &?the Path Forward
Despite these positive strides, challenges remain. The significant system-wide changes, including the introduction of over 700,000 immigrants to full Medi-Cal coverage and the redetermination process post-pandemic, require careful navigation. The state must manage these changes without overwhelming staff or confusing enrollees—no small feat given the scale of the undertaking. Moreover, the health workforce crisis poses a potential hurdle to these ambitious plans. As Medi-Cal expands and innovates, the demand on health professionals will only grow. Addressing this labor shortage is critical to fulfilling the promises of better care and greater equity.
Why It’s Exciting
This is a watershed moment for California’s health care system. The sweeping changes to Medi-Cal reflect a bold commitment to health equity and quality care. For Californians who have long dreamed of a more accessible and responsive health care system, these reforms offer hope and a glimpse into a promising future.
The Role of HT4M in California
Working with Health Tech for Medicaid (HT4M) is more important than ever. HT4M plays a crucial role in driving the adoption and implementation of innovative health technologies within the Medicaid ecosystem. As Medi-Cal undergoes these significant transformations, the collaboration with organizations like HT4M ensures that cutting-edge solutions are tailored to meet the specific needs of California’s diverse Medicaid population. HT4M’s expertise in fostering partnerships and advancing technology solutions can help maximize the impact of these reforms on service delivery and patient outcomes.
Collaborative Call to Action
This is a watershed moment for California’s health care system. The sweeping changes to Medi-Cal reflect a bold commitment to health equity and quality care. For Californians who have long dreamed of a more accessible and responsive health care system, these reforms offer hope and a glimpse into a promising future. HT4M is here for riding the waves!
In essence, for anyone connected to California's Medi-Cal system—whether as a beneficiary, provider, or advocate—there's much to be hopeful about. "California dreaming" isn't just a state of mind; it's a vision for a healthier, more equitable future that's starting to become a reality. ?Work with HT4M for the amazing road ahead.
With warmest regards,
Adimika Arthur
CEO & Executive Director
Health Tech for?Medicaid (HT4M)
Diving into California's Healthcare Currents
Making a splash in Dana Point at the Health Evolution Summit
The 2024 Health Evolution Summit united influential CEOs from health systems, health plans, and life science organizations, alongside key policymakers in early April. With a dedicated focus on driving the transformation of healthcare, this intimate gathering convened participants to engage in candid discussions, foster innovative ideas, nurture meaningful relationships, and igniting the spark of creative solutions crucial for the industry's evolution.
Among the impactful sessions, Adimika joined the "Medicaid in the Spotlight: Unpacking Opportunities for Growth, Innovation, and Advancing Health Equity" panel alongside Secretary Kody Kinsley of the North Carolina Department of Health and Human Services, Kelly Munson , CEO of AmeriHealth Caritas, and Philip Ozuah , MD, PhD, President & CEO of Montefiore Health System.
Exploring state healthcare innovation in Berkeley
The University of California, Berkeley, Goldman School of Public Policy hosted an alumni career event focused on enhancing health initiatives in North Carolina and California. Adimika Arthur attended in support of esteemed state leaders, Kody Kinsley , Secretary of Health and Human Services for North Carolina, and Corrin Buchanan , Deputy Secretary for Policy and Strategic Planning in California.?
Navigating the state of healthcare in America with Secretary Xavier Becerra
Adimika convened in San Francisco, CA for discussions on the state of healthcare in America with Secretary of the Department of Health and Human Services, Xavier Becerra . A native Californian, Becerra has been a prominent advocate for healthcare access and immigration reform throughout his career.
Upcoming Events
The Inland Empire Health Plan's Mission Conference in?Rancho Cucamonga
Join us at the the annual Mission Conference as we aim to inspire greater heights of courage, compassion, and collaboration. Through IEHP's Mission to "Heal and Inspire the Human Spirit," the organization intentionally seeks courageous and creative ways to cultivate compassion and enhance well-being for all who call the Inland Empire home.
As a spotlighted speaker, Adimika will leverage her unique experience and expertise as she speaks on "Compassion in Community: Embracing Our Collective Call."
Details:
?? Date: Friday, May 3, 2024?
?? Location:?IHEP Headquarters,?10801 6th St. Ste 120. Rancho Cucamonga, CA
Join HT4M & CMA in San Francisco May 7-8!
领英推荐
Save the date and? join HT4M & CMA in San Francisco for The?2nd Annual Health IT Summit:?"Health IT in the Safety Net."
As California works to expand coverage to underserved populations, health IT can play a pivotal role in ensuring equitable access to care. The 2nd Annual?Health IT Summit will bring together thought leaders from across California and the nation to explore how to make that vision a reality.
Building off the huge success of last year’s sold-out summit,?a diverse and engaged set of attendees is expected,? including?physicians, medical groups and IPAs, health plans, health information organizations (HIOs) and others who will take the learnings from this conference to change how care is delivered in this state.
Details:
?? Date: May 7-8, 2024
?? Location: Grand Hyatt at SFO in San Francisco
?? Find speakers, the agenda, and additional event details here .
Register to attend below! Use the code?"HT4M" for $50 off?registration. Interested?in volunteering ??Or want to be a sponsor??Check out the forms here:
Venture for Older Adults in San Francisco?
Now in its 21st year, the What’s Next Longevity Venture Summit continues its mission to bring together top industry entrepreneurs, investors, thought leaders, analysts, media, and innovators, all to help you advance your business and expand your network of experts in the longevity economy.
The theme for the 2024 Longevity Venture Summit is Net New: Investment, AI, & Innovation in the Longevity Marketplace. This year we are developing sessions and selecting speakers that will ensure our continued commitment to the collaboration of forward-looking entrepreneurs and investors.
It’s more than an event—it’s an opportunity to shape the future of innovation in aging and healthcare!?
Details:
?? Date: June 11-12, 2024
?? Location:?The Fairmont San Francisco
?? Find speakers and additional event details here .
Register to attend below! Use the code?HT4M20 for a 20% discount.
State of the State: Medicaid in California
The Californian?Medicaid program, or Medi-Cal, serves as the predominant health insurance provider for over 15 million individuals in California, constituting 1/3 of the state's population. It?extends health coverage to low-income children and their parents, pregnant people, older adults, and people with disabilities. For seniors with limited financial means, Medi-Cal offers coverage for services not covered by Medicare, such as nursing home care.
Receiving substantial funding from both federal and state sources and serving as a crucial healthcare lifeline for millions of Californians, this program holds a significant position in state budget and policy dialogues, consistently showcasing leadership and innovation among state Medicaid initiatives.
Medicaid Redetermination
During the COVID-19 Public Health Emergency (PHE), all states temporarily paused Medicaid disenrollment or member "churn" to secure increased federal funding. However, with the Consolidated Appropriations Act mandating the resumption of continuous coverage by March 31, 2023, disenrollments in California began in April. This led to a significant decline in enrollment by 1,035,652 from March to January 2024, as reported by KFF . Despite this, California's utilization of federal flexibilities, such as ex parte eligibility determinations, has facilitated smoother processes. Additionally, the state has introduced various beneficial policies and practices during the unwinding process. For deeper insights, refer to the comprehensive Medi-Cal redetermination data provided by the California Health Care Foundation here .
Calling All Future Medicaid Leaders!
Are you a motivated and passionate student ready to drive change in Medicaid? Our fellowship program offers an exclusive opportunity to deeply explore vital areas such as health equity, community engagement, and revolutionizing healthcare delivery and payment systems. As a fellow, you'll gain invaluable hands-on experience, access to inspirational leadership opportunities, and exposure to the forefront of Medicaid advancements.
Benefit from our longstanding partnerships with esteemed institutions such as Mount Sinai Health System, University of California System, Johns Hopkins University, and Tulane University, ensuring you receive real-world experiences that will elevate you as a future leader in Medicaid.
Ready to make your mark? Apply now and be part of shaping the future of Medicaid!
Become a Member at HT4M!
Empower HT4M: Help Us Pave the Way to 5 Years of Impact
By converging with?diverse experts and leaders,?HT4M paves the channel for change.??As a member, you'll:?
???Unlock Insights:?Gain a deeper understanding of Medicaid and stay updated on the latest trends.?
???Drive Change:?Influence Medicaid's future through policy advocacy and partnerships.
???Inspire Innovation:?Join a passionate community dedicated to solving healthcare's biggest challenges.
As a member of HT4M, you're not just joining an organization; you're joining a movement!