The Medi-Cal program is failing children, and the state must urgently make managed health care plans accountable, a large coalition of youth advocacy groups said Tuesday in a letter to the Administration of California Gov. Gavin Newsom.
The Children’s Movement – a group of more than 600 organizations – recommended that the California Department of Health Care Services take steps to ensure that providers offer quality, equitable plans addressing children’s health problems before they get out of hand.
“For far too long, these contracts have lacked the accountability and oversight needed to guarantee even the most basic health care needs of children,” the letter stated.
The Children’s Movement sent the letter in the wake of a report by Children Now, which found that California ranks 50th in America on well-baby screenings and that not even half (48%) of kids covered by Medi-Cal managed care plans saw their doctor annually for a check-up. About 5 million California children rely on Medi-Cal for their health care.
The state is currently renegotiating $5 billion in Medi-Cal contracts.
In some counties, only 10% of infants and toddlers on Medi-Cal had their pediatrician-recommended developmental screenings, and plans routinely fell short of minimum performance standards prescribed by contract and, in some cases, by law, Children Now found.
In its letter, the coalition backed Children Now’s recommendation that the Newsom Administration link health plan reimbursement to contract performance, with higher rates for better health outcomes and lower reimbursement for poorer outcomes.
“Gov. Newsom should commit to improving health care access and quality of care, especially preventive care, for kids,” said Mike Odeh, director of health services for Children Now. “Fixing Medi-Cal’s broken managed care contracts is a once-in-a-childhood opportunity to deliver on that commitment.”