On Friday, the Department of Health Care Services (DHCS) joined
with five commercial managed care plans (MCPs) – Blue Cross of
California Partnership Plan (“Anthem”), Blue Shield of California
Promise Health Plan, CHG Foundation d.b.a. Community Health Group
Partnership Plan, Health Net Community Solutions, Inc., and
Molina Healthcare of California – to announce
an agreement to deliver Medi-Cal services to Medi-Cal managed
care members in 21 counties across the state starting in January
2024.
This agreement revises the initial plan of notices of intent to
award released in August 2022 by DHCS to limit Medi-Cal contracts
to just three commercial plans (vs. the existing nine) plus
Kaiser under a separate agreement. As part of the new agreement,
DHCS notes Medi-Cal health plans will be held to new standards of
care and greater accountability, helping ensure Medi-Cal members
have the care and support they need to live healthier, more
fulfilling lives.
These plans, and all other Medi-Cal managed care plan partners,
will operate under the new MCP contract to provide quality,
equitable and comprehensive coverage for Medi-Cal managed care
members. To help address the social drivers of health, the new
contracts require partnerships with local health departments,
local educational and governmental agencies, and other local
programs and services, including social services, child welfare
departments, and justice departments, to ensure member care is
coordinated and members have access to community-based resources,
including Community Supports.
Below are the plans and the counties they will serve:
Blue Cross of CA Partnership Plan (“Anthem”) –
Alpine, Amador, Calaveras, El Dorado, Fresno, Inyo, Kern, Kings,
Madera, Mono, Sacramento, San Francisco, Santa Clara, Tuolumne
Blue Shield of CA Promise Health Plan – San
Diego
CHG Foundation d.b.a. Community Health Group Partnership
Plan – San Diego
Health Net Community Solutions, Inc. – Amador,
Calaveras, Inyo, Los Angeles (with subcontract to Molina for 50%
of membership), Mono, Sacramento, San Joaquin, Stanislaus,
Tulare, Tuolumne
Molina Healthcare of CA – Riverside, Sacramento,
San Bernardino, San Diego, Los Angeles (subcontractor to Health
Net for 50% of membership)
