In "Will it work?" (June 30, p. 120) L.A. Care Health Plan is incorrectly blamed for delaying full implementation of a managed-care plan for Medi-Cal beneficiaries in Los Angeles County. The delays stem from HCFA's desire to see more progress from the California Department of Health Services in addressing HCFA's concerns with the implementation. The responsibility for implementation is exclusively the state's.
The article also states that Maximus is a subcontractor of L.A. Care and suggests that education and enrollment of beneficiaries is the responsibility of L.A. Care. In fact, neither is true. The state of California is responsible for education and enrollment. Maximus is the state's contractor for carrying out these activities.
L.A. Care strongly believes that beneficiaries must clearly understand the changes occurring in Medicaid and the choices available to them. Besides working with advocates, providers, consumers and the state to improve the process, L.A. Care developed its own brochures in eight languages and a video to educate beneficiaries about enrollment and choosing a doctor.
Our commitment is to create a system of care in which beneficiaries have a medical home and access to primary and specialty care. Our goal is that very soon mothers and their children will no longer wait for hours in an emergency room to receive their primary care. We intend to make that scenario an uncommon occurrence.
Will the two-plan model work? Yes. Every transition to managed care in the Medicaid arena has experienced bumps in the road. Los Angeles County is no different. Many issues are unresolved, but we have seen a willingness on the part of the stakeholders to sit down and work them out.
Anthony D. Rodgers
Chief executive officer
L.A. Care Health Plan