A Bridge to Healthcare Reform
Early Implementation Highlights
In California we are now starting to see some of the early implementations of health reform programs approved by the federal government. These reforms are contained in California’s 1115 Waiver, entitled “Bridge to Reform.”
One area of change is the County Medical Services Programs (CMSP) program. The County’s CMSP Program has been renamed the Health Program of Alameda County (HealthPAC) and became effective July 1, 2011. This program, although not technically considered health coverage, provides free or low-cost health care with “health plan like” features similar to managed care for adults at or below 200% of the federal poverty level who do not qualify for Medi-Cal
Behind the scenes, the Alameda Alliance for Health is providing third party administrative services to the County that include HealthPAC participant cards, eligibility information, a participant Customer Care phone number, medical management, and data analysis. The County is continuing to work with the provider community in the development of a common formulary, quality improvement measures, delivery of mental health services, and case management.
Another area of reform focuses on Medi-Cal only beneficiaries with senior and disabled (SPD) aid codes. These patients began transitioning into managed care beginning June, 2011.
CHCN is working with both, Alameda Alliance of Health and Anthem Blue Cross, in order to smoothly transition the clinics’ SDP fee-for-service patients to managed care programs. CHCN’s new SPD membership in the last several months has risen sharply to over 4500 patients. The PCP assignment process, continuity of care with specialists, health risk assessments, and complex case management have been CHCN’s focus during this transition period. Please contact CHCN with any questions.