Medi-Cal Managed Care 101
Understanding Medi-Cal managed care fundamentals
February 11, 2019
The California Endowment
Are you new to Medi-Cal managed care or want a refresher on managed care fundamentals? Make plans now to attend this one-day introductory course designed to help participants better understand the essential concepts behind Medicaid, Medi-Cal and Medi-Cal managed care.
The course will cover:
- Medi-Cal program basics
- How Medi-Cal fits within the broader California health care landscape
- The different Medi-Cal managed care models and how they work
- How the state regulates and oversees Medi-Cal managed care plans
- Managed care principles and key plan functions
- Current and future issues in Medi-Cal managed care
Who should attend:
All plan staff are welcome; however, this introductory course may be most valuable and informative for those who are new to managed care and the Medi-Cal environment.
*May be subject to change
9:30 a.m. – Noon
What is Medi-Cal?
- Overview and history of Medicaid and Medi-Cal
- How Medicaid and Medi-Cal fit within the broader health
- Who is covered and how it’s financed
Medi-Cal Managed Care Models
- Understanding the various models of managed care
- Differences between managed care and fee-for-service
- What services are/are not included in Medi-Cal managed care
Program Oversight & Regulation
- Role and functions of the Department of Health Care Services (DHCS)
- How Medi-Cal managed care aligns with DHCS’ larger mission
- Department of Managed Health Care’s role in the regulation and oversight of Medi-Cal managed care plans
Noon – 1:00 p.m. | Hosted Luncheon
1:00 – 4:00 p.m.
Managed Care Principles and Payment
- Overview of managed care principles and concepts, and their application within Medi-Cal managed care plan operations
- Risk mitigation and risk spreading concepts
Key Functions of Managed Care Plans
- Operational areas and functions
- How each of the functional areas are interrelated
- Case scenarios
Current & Future Issues in Medi-Cal Managed Care —
- State and federal policy changes that may affect Medi-Cal managed care
- New programs and opportunities for managed care plans
Elizabeth Darrow is a seasoned health care executive with more than 20 years of experience in managed care, focusing exclusively on Medicare and Medicaid programs. Most recently she was the Chief Executive Officer of the largest Medi-Cal managed care plan in Santa Clara County. Among other roles, Ms. Darrow also previously served as Executive Director of Government Programs at New West Health Services in Montana and Medicare Director for Schaller Anderson in Arizona. Currently, Ms. Darrow works as a consultant with various California health plans focused on Medicare and Medi-Cal. Ms. Darrow is a graduate of the Ohio State University with a Bachelor of Science and Master of Arts.
Blue Sky Consulting
Dr. Finocchio has more than 20 years of health policy research and implementation experience in government, academia, advocacy and philanthropy. Most recently he was a senior researcher at Mathematica Policy Research. Previously, Dr. Finocchio was part of the Brown Administration’s team as Associate Director at the California Department of Health Care Services leading the implementation of the Affordable Care Act. While a Senior Program Officer at the California HealthCare Foundation, Dr. Finocchio led program strategy, grantmaking, and research in the areas of health services for the uninsured, Medicaid and CHIP programs, and safety net capacity. He has also held senior health policy positions at the Institute for Health Policy Solutions, Children Now and UC San Francisco Center for the Health Professions. He has published articles in Health Affairs, Academic Medicine, the Journal of General Internal Medicine and the American Journal of Public Health.
Jane Ogle is the former Deputy Director for Healthcare Delivery Systems at the California Department of Health Care Services, where she was responsible for the Low Income Health Program that ultimately transitioned 640,000 childless adults into Medi-Cal in 2014; the Long Term Care division that oversees programs for the most at risk older adults in the state; California Children’s Services; and the Managed Care Division that expanded Medi-Cal managed care to all 58 counties and transitioned 900,000 children from Healthy Families into Medi-Cal. She was responsible for the Coordinated Care Initiative in seven counties that integrates Medicare and Medi-Cal services with long term services and supports through managed Medi-Cal health plans. Prior to her work at the state, Ms. Ogle was the first COO at Santa Clara Family Health Plan and spent more than 20 years in hospital administration at hospitals in Trenton and Princeton, New Jersey. Ms. Ogle is a graduate of Georgetown University, School of Foreign Service.
The California Endowment
1414 K Street, Suite 100
Sacramento, CA 95814
Registration Fees: $21.59 per registrant
Registration Details: The course will accommodate up to 80 participants. Each plan may elect to send no more than five (5) participants. If more than five individuals from a plan are interested in attending, they are encouraged to sign up for the waitlist. Waitlisted individuals will be admitted should space become available.
Registration Deadline: Registration closes Feb. 6 at 5:00 p.m or once capacity is reached.
Registration Confirmation: Registrants will receive an email notification confirming their registration.
Presentation Materials: Presentation materials will be made available electronically only via the program resource web page that will be provided to confirmed registrants. Attendees are encouraged to download the materials in advance to their mobile device or print a copy to bring to the event.
Special Accommodations: Please contact the LHPC Institute at email@example.com should you require special accommodations pursuant to the Americans with Disabilities Act.
Cancellation Policy: Cancellation notification must be submitted in writing to firstname.lastname@example.org seven or more days prior to the course date. Refunds will not be given after that date. Substitutions are encouraged.