The tax payers of America shouldn't be paying for wealthy Americans healthcare! You all do realize that people with and without commercial insurance have had drug shortages since 2020. Change and United Healthcare should of been used for the poor. Instead the wealthy have used it for themselves.
California has the one of the highest population compared with other states and even larger than most countries. So when we look at the numbers of people who have Health Plan benefits compared with other states or counties it’s pretty obvious that we are the worst with managing the population and allocating resources properly. We have CalPath and a CalAIM system in place to help create a community health system that is whole person focused yet we spend more money on public health services that don’t work after hours or weekends. We burden FQHCs with an impossible volume of patients to manage. We have statics that prove less than 50% of members with PCP encounters. The IHSS system is fragmented from the Health Plans. Face it the CHDP program failed and was twilighted. Every MediCal Managed Care Plan fragments the delegation to the point that HP never talk directly with any member in any California Hospital. FYI, I work in one of the largest California hospitals and not once has a Medicaid HP every taken ownership of management of their members care to ensure follow up or engagement with disease management. The DxF has failed to include IHSS data or Home Health Care data. When will public funded MediCal and Blue Cross Plans be accountable for managing their members care!
Have we thought about the obvious? Every year Health Plans are signing up millions of Americans but offering marginal benefits and just waiting for spending on the “outliers” that will be the 90% of the revenue generated on 10% of the members. So it’s only a matter of time until they go bankrupt or trigger their Stop Loss insurance on those chronically ill that have been unable to access routine care.
26 letter password with numbers and characters that has to be changed quarterly and has a 2 step authentication process. This is the life of a WFH employee lol
Village MD/Walgreens Pharmacy is leading the charge that VBC has misled by having more access and engagement with patients and having physicians invested in improving outcomes by actively addressing care needs. Having everyone on the same EHR is just part of it. Enrollment into tech supported CM/DM programs all together on one “dashboard” is also key. And finally ALL patient care IS personal and understanding that real people with family members are behind all the data is priority! Thanks for sharing
I’m part of many PATH CalAIM groups and they’re all struggling with the fragmented (non-existing) HIE system and the lack of transparency and accountability between the Dept of Social Services, Housing and other agencies that do not provide adequate assistance to make sure patients are engaged with their Health Plans and their PCP’s. California just spent millions of dollars recently requiring MediCal Health Plans RFP for only 19% of the total MediCal and didn’t require State and County MediCal Health Plan do the same, even though they manage 81% of the MediCal. The systems need disruption and accountability from those State and County Departments and Health Plans if anything is going to change. Just look at the numbers. MediCal Health Plans are failing and patients continue to use the ER as the PCP and the PCP has no idea about the Disease Case Management Programs
