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Board unanimously approves CalOptima step toward Covered California participation; supervisors ask focus on Medi-Cal ‘churn’
Summary
The Board of Supervisors adopted an ordinance enabling CalOptima to pursue participation in Covered California; supervisors and local providers said the change should focus first on people cycling on and off Medi-Cal to maintain continuity of care.
The Board of Supervisors unanimously adopted on Jan. 14 an ordinance that allows CalOptima Health to pursue participation in Covered California, a move county officials and health-care providers said aims to reduce gaps in coverage for residents who move in and out of Medi-Cal.
Supporters said the change will give patients who lose Medi-Cal eligibility continuity of care and reduce reliance on emergency care. Dr. Dylan Tran, CEO of Family Choice Medical Group, said many of his patients who lose Medi-Cal “have nowhere to turn” and that continuity through Covered California could prevent repeated hospital admissions. “Joining Covered California will provide much needed community care for our patients by ensuring that we can continue to provide important medical services regardless of changes in income,” he told the board.
Peter Baranoff, CEO of KPC Health, which represents four Orange County hospitals, said the move will help bridge “churn” — the ebb and flow of coverage — and could lower the overall cost of care by enabling more preventive and routine services.
Board members pressed CalOptima and staff to limit short-term outreach costs and to target those most likely to cycle between Medi-Cal and Covered California. Supervisor Janet Nguyen (referred to by transcript as Wynne in some remarks) said she sought an explicit commitment that CalOptima’s initial outreach focus be on the population that fluctuates in and out of Medi-Cal, not broad advertising for new enrollees. CalOptima staff and board members told supervisors they had adopted guiding principles to focus outreach on that population.
Supervisor Katrina Foley said the county should also ensure provider networks and payment rates support access and that county funding intended for Medi-Cal beneficiaries not be redirected to broad marketing. CalOptima said its board-approved guiding principles emphasize outreach to the churn population and that county funding would be used to support continuity of care for those residents.
The ordinance moved forward after a public comment period that included supportive remarks from medical providers and hospital executives and a critic who linked the broader state policy to other state budget choices. The board voted to adopt the ordinance on its second reading and directed staff and CalOptima to coordinate outreach with an emphasis on continuity for residents transitioning between Medi-Cal and Covered California.
