California gives Kaiser Permanente a state-wide contract with no bids to serve Medi-Cal registrants under a closed-door transaction under the administration of Governor Gavin Newsom, and the governor’s generosity. He questioned supporters’ incentives in other medical plans.
The secret of special accommodation for Kaiser has infuriated other providers. Part of it is in the process of open bidding as the state overhauls a healthcare program that serves approximately 14 million low-income earners. Meanwhile, according to local health plans, the deal will allow Kaiser to select healthier registrants and allow other healthcare providers to cover a higher percentage of the state’s most ill and most expensive patients. ..
The Newsom administration said it would seek power from Congress to approve a contract that had not yet been announced.
“This is a safety net Medi-Cal distribution system that exists only to provide poorly serviced services and is solely responsible to the general public and is continuously working to improve the Medi-Cal distribution system. Prioritize the interests of large corporations over profits. That’s right, there is no other motive, “says 16 community medicines that serve more than 70% of Californians enrolled in Medi-Cal managed care. Linnea Koopmans, Chief Officer of the California Community Health Program, which represents the project, said.
As reported Thursday, state officials attempted to weaken the claim that Kaiser was receiving a “lover’s deal” on Friday. Kaiser Health NewsThe healthcare company said it would follow the same conditions as any other plan needed to go through the bidding process. However, Kaiser maintains some provisions that allow the plan to exclude most Medi-Cal registrants. For example, Kaiser generally does not accept new Medi-Cal registrants unless the person has a recent background with an insurance company or an insured family member.
Under the new agreement, Kaiser will continue to limit which Medi-Cal subscribers it accepts while providing compensation for foster care and Medicare-qualified adolescents.
Jarod McNaughton, Chief Executive Officer of the Inland Empire Health Program, said: “It’s much easier for healthy people to get a quality score than for the most deprived. That gap is our concern.”
Serving 9 million Californians, Kaiser has built a formidable political presence in the Capitol and routinely donates millions to politicians and their causes. Last year, Newsom used Kaiser to support the state’s vaccine program. In 2020, Kaiser Top payment donors Made a charitable donation of $ 35.5 million to Newsom on behalf of the Governor.
Michelle Baass, director of the state’s healthcare services division, which oversees Medi-Cal, said the deal with Kaiser is part of the state’s greater efforts to reshape the healthcare program and improve the quality and fairness of health. Said that. As Kaiser is an insurance company and a healthcare provider, Bath said the system is limited in the number of patients it can provide and where it can physically care for its registrants. It complicated Kaiser’s ability to be part of the formal bidding process with other plans, Bath said.
Without making another path for Kaiser, state officials said they were at risk of losing top-quality plans affecting the 900,000 Medi-Cal registrants currently in Kaiser. Under the New Deal, Kaiser promises to increase 25% of new Medi-Cal registrations compared to the five-year contracts in the 32 counties it currently operates.
“This proposal acknowledges that they have their own structure and therefore proposes to enter into this direct contractual relationship,” Mr. Bath said.
Dr. Bechara Choucair, Kaiser’s Chief Health Officer, said the new contract will enable healthcare companies to provide quality care to more people who rely on the state’s safety net system.
“The goal is not for Kaiser Permanente to compete with the safety net, but to support it,” says Choucair. “We are not competing with other Medi-Cal plans for our members and we are not aiming to turn off profits from Medi-Cal registration. Kaiser Permanente is a non-profit to improve the health of the community. Participating in Medi-Cal because it is part of our mission. We serve. “
However, this change will result in the loss of hundreds of thousands of subscribers to local health insurance that Kaiser had taken care of through subcontracting with local insurance. They will lose millions of dollars as local health insurance is discontinued.
For the Inland Empire Health Plan, the Kaiser contract could mean losing 144,000 Medi-Cal registrants in Riverside and San Bernardino counties. That’s equivalent to the $ 9 to $ 10 million annual loss Kaiser paid to the Inland Empire program for community support and administration costs not provided in the commercial program, McNorton said.
Critics question why the state offers expansion contracts to serve Kaiser to the poorest residents of California, given what healthcare companies have long faced. Criticism — And status Sanctions and fines — for that Mental health care..
Anthony Wright, executive director of advocacy group Health Access California, said the deal would allow the state to further monitor Kaiser, “a step in the right direction.”
“As Kaiser works well with many quality indicators, it can and should be better,” Wright said. “Arrangements between [the state] Kaiser needs to include requirements to maintain or improve Kaiser’s record of quality and impartiality as Kaiser undertakes more of this vulnerable population, especially given their uneven record of behavioral health. I have. “
This story was originally Los Angeles Times..