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a geographic managed care model with multiple plans per county, a regional managed care model with 1-2 commercial health plans in many counties, and unique one-county models in San Benito, Imperial counties and the bi-county plan "CenCal Health" in San Luís Obispo and Santa Barbara. In Denti-Cal, the majority of beneficiaries are covered ...
In the 1980s, as Medicaid managed care expanded across the county, safety net providers, such as Community Health Centers (CHCs) and public hospitals, feared that managed care would reduce reimbursements for Medicaid-eligible services, making it more difficult for them to provide care to the un- and under-insured, and result in a loss of Medicaid volume, as beneficiaries would choose to see ...
The Department of Managed Health Care (DMHC) is a regulatory body governing managed health care plans, including Health Maintenance Organizations (HMOs) and most Medi-Cal managed care plans in California. The DMHC was created as the first state department in the country solely dedicated to regulating managed health care plans and assisting ...
As of 2015, about 14.1 million people were insured privately, including in self-funded plans; 1.3 million were in plans regulated by the CDI and 12.7 million were in plans regulated by the DHMC. [9] Kaiser Permanente had about 50% of the market, followed by Blue Shield of California, Anthem Blue Cross, and Health Net (a subsidiary of Centene). [9]
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In 1993, the State Department of Health Services produced a report entitled “Expanding Medi-Cal Managed Care: Reforming the Health System – Protecting Vulnerable Populations” which served as a blueprint for expansion of Medi-Cal managed care. It designated L.A. County as one of the areas for the “Two-Plan Model” where a locally ...
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