Medicaid Managed Care: More Competition and Oversight Would Improve California's Expansion Plan

United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Health, Education, and Human Services Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 1995-04-28 monographic deposited born digital 45 p. GA 1.13:HEHS-95-87 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-95-87 P0b002ee18038a7bc f:he95087 DGPO 2010-08-12 2011-03-23 GAOREPORTS-HEHS-95-87 machine generated eng fdlp REPORT GAOREPORTS-HEHS-95-87 HEHS-95-87 Medicaid programs State-administered programs Health care services Health care programs Beneficiaries Disadvantaged persons Health maintenance organizations Quality assurance Women Children California Medi-Cal Program California Prepaid Health Plan Program California County Organized Health Systems Program California Geographic Managed Care Program California Primary Care Case Management Program AFDC Aid to Families with Dependent Children Program Supplemental Security Income Program California Medicare Program Early and Periodic Screening, Diagnosis, and Treatment Program Los Angeles County (CA) Solano County (CA) Santa Barbara County (CA) San Mateo (CA) Letter Report HEHS Medicaid Managed Care: More Competition and Oversight Would Improve California's Expansion Plan Pursuant to a congressional request, GAO reviewed California's Medicaid managed care program, focusing on: (1) state oversight of managed care contractors; (2) state plans for expansion; and (3) key issues in implementing the expanded program.<p/>GAO found that: (1) California plans a major expansion of its Medi-Cal managed care program in selected counties; (2) by the end of 1996, the number of enrollees in California managed care plans will total over 3.4 million, almost four times the number currently enrolled; (3) enrollment will be mandatory for women and children, who will choose from one of two plans, unlike the current voluntary system with several choices; (4) mandatory enrollment could magnify the problems already associated with California's Medi-Cal program, such as availability and quality of services, capabilities of management staff, and providers' financial incentives to limit care; and (5) any benefits of competitive managed care could be lessened by California's decision to limit beneficiaries to two health plans. https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-95-87/html/GAOREPORTS-HEHS-95-87.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-95-87/pdf/GAOREPORTS-HEHS-95-87.pdf GAO/HEHS-95-87 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-95-87 Letter Report GAO/HEHS-95-87; Medicaid Managed Care: More Competition and Oversight Would Improve California's Expansion Plan; Medicaid programs State-administered programs Health care services Health care programs Beneficiaries Disadvantaged persons Health maintenance organizations Quality assurance Women Children California Medi-Cal Program California Prepaid Health Plan Program California County Organized Health Systems Program California Geographic Managed Care Program California Primary Care Case Management Program AFDC Aid to Families with Dependent Children Program Supplemental Security Income Program California Medicare Program Early and Periodic Screening, Diagnosis, and Treatment Program Los Angeles County (CA) Solano County (CA) Santa Barbara County (CA) San Mateo (CA)