Nearly one million people served by Medi-Cal, California’s Medicaid managed care program, have a disability or chronic condition. Yet, there are limited ways to determine how well Medi-Cal is serving this group with complex health care needs. Developing a systematic way to assess health care quality for this population is now more critical than ever because California is proposing to enroll an additional 340,000 people with disabilities and chronic illnesses into managed care by January 2007.
California’s challenge is similar to other states that enroll people with disabilities and chronic needs into Medicaid managed care – i.e., how to provide the most effective care for this medically complex population and how to measure the program’s success. To help Medi-Cal best serve the needs of this diverse population, The California HealthCare Foundation selected the Center for Health Care Strategies to lead a team, which includes The Lewin Group and Western University’s Center for Disability Issues and the Health Professions, to identify a set of performance standards and measures that Medi-Cal can use to evaluate health care services for people with disabilities and chronic needs. Medi-Cal can use these measures to revise its contract language and procedures for monitoring health plans. The standards and measures will reflect the unique and diverse needs of people with disabilities and will promote a more comprehensive, holistic system of health care.
Information from the project will be disseminated nationally and through the California HealthCare Foundation’s Web site to help other states better serve adults with disabilities and chronic conditions.