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California’s Physician Groups Support MOU Advancing Coordinated Care Demonstration Project For State’s Medi-Cal/Medicare Patients

California’s physician groups gave their encouragement and support last week for the memorandum of understanding between the federal -Medicaid Coordination Office and California’s Health and Human Services Agency to move ahead with a three-year, eight-county for seniors and people with disabilities who are eligible for both Medi-Cal and Medicare. The MOU indicates a start date of October 2013 for the program that aims to create a seamless service delivery experience for dual eligible beneficiaries, with the ultimate goals of improved care quality, better health and a more efficient delivery system.

The California Association of Physician Groups () represents virtually all of California’s capitated, accountable, multispecialty physician groups who, in turn, provide care to approximately 20 million Californians.

“It makes no sense for this patient population to continue to languish in a fragmented, unaccountable system of care that is now failing due to the public budget crisis in California,” said John Jenrette, M.D., Chair of CAPG’s board of directors ¬†and CEO of Sharp Community Medical Group. “The sooner these patients are moved into a system where their care is coordinated among providers, the faster we can all get to work on providing better service to them in an accountable and cost-effective manner that will ultimately provide greater fiscal efficiency for the Medi-Cal and Medicare systems. The demonstration will help ensure that these patients get the right services at the right time and the setting of their choice.”

“CAPG members have served the dual eligible patient population under the Medicare Advantage program for years and are poised to serve the incoming beneficiaries in the coordinated care model proposed by this demonstration project, said Donald H. Crane, CAPG president and CEO. “In fact, the majority of our member physician groups have been doing this far longer than the Medi-Cal managed care plans with which they will be contracting to deliver services to this patient population.

“This demonstration is about improving the coordination of health care services for people with Medi-Cal and Medicare and gives them the opportunity to combine their benefits into one health plan — and receive more coordinated and accountable care than available in today’s fragmented fee for service system,” said Crane.

In a letter sent in February to the federal Medicare-Medicaid Coordination Office and California’s Health and Human Services Agency, CAPG strongly supported the goals of the demonstration program and urged swift implementation, stating: “We are confident that these dual eligible patients will fare far better inside our coordinated care delivery system than in a fragmented, fee-for-service based system. Any short term challenges in implementing this Demonstration will be outweighed by the higher quality, lower cost care these patients will receive.”


Source: California Association of Physician Groups (CAPG)