LA Care: DHCS Announces Change to Cal MediConnect Program in Los Angeles County

From our colleagues at LA Care Health Plan: 

On Tuesday, February 4, the Department of Health Care Services (DHCS) announced that DHCS and CMS will be directly contracting with CareMore, Care1st Health Plan and Molina in addition to Health Net and L.A. Care for the Cal MediConnect program in Los Angeles County. This means that CareMore and Care 1st will not be subcontractors to L.A. Care for the Cal MediConnect program, but choice, which was our original intent in subcontracting with them, will be maintained.

L.A. Care’s Cal MediConnect program will be open for voluntary enrollment starting April 1, and passive enrollment once our Medicare Stars Low Performing Icon (LPI) is resolved. Our overall CMS Star rating is 3.0 stars, of which we are very proud. We are continually implementing strategies to improve our Star Ratings, and we anticipate that our Part D rating will rise in next year’s review period and that the LPI rating will be gone in the coming months.

L.A. Care’s lead role in the other main component of the Coordinated Care Initiative (CCI) will remain unchanged, which includes the delivery of managed long term supports and services (MLTSS) directly and through our Medi-Cal subcontractors: Anthem Blue Cross, Care1st Health Plan, and Kaiser Permanente.

While we are disappointed in the DHCS decision to change the Cal MediConnect model so close to its launch in Los Angeles County, we firmly believe that the concept of transitioning these high need people into a coordinated system of care is the right thing to do. For more than two years, L.A. Care has been spearheading collaborations to design the delivery system for dual eligible (Medi-Medi) people. We are continually meeting with doctors, advocates, caretakers, current members and other stakeholders to develop a comprehensive and culturally sensitive program.

Ultimately, while challenges to implementation remain, we will continue to work collaboratively with CMS, DHCS and the other Cal MediConnect plans to ensure the most vulnerable members of our community receive the quality of care and simplified delivery system they deserve.

Visit www.calmediconnectla.org to learn more about L.A. Care’s Cal MediConnect program.

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  • LAAAC is managed by St. Barnabas Senior Services; Funded, in part, by Archstone Foundation.
  • St. Barnabas Senior Services

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