{"id":14442,"date":"2012-07-06T19:26:08","date_gmt":"2012-07-06T19:26:08","guid":{"rendered":""},"modified":"2012-07-06T19:26:08","modified_gmt":"2012-07-06T19:26:08","slug":"california-patients-struggling-under-managed-care","status":"publish","type":"post","link":"https:\/\/calitics.com\/index.php\/2012\/07\/06\/california-patients-struggling-under-managed-care\/","title":{"rendered":"California Patients Struggling Under Managed Care"},"content":{"rendered":"<p>California approved moving patients enrolled in Medi-Cal, the state&#8217;s Medicaid program, to a managed care system last year, and the transition has been a rocky one for many California patients, according to an article in the <i>LA Times<\/i>. The purpose of the transition is to cut millions from the Medi-Cal budget to help the state&#8217;s rocky economy. A noble pursuit to be sure, but at what cost? If reforming Medi-Cal causes patients with disabilities, the elderly, and the chronically ill to lose access to the medical care they so desperately need, is it worth it? <\/p>\n<p>According to the <a href=\"http:\/\/www.latimes.com\/news\/local\/la-me-managedcare-disabled-20120702,0,7549313.story\">article<\/a>:<\/p>\n<blockquote><p>But for some of these low-income seniors and disabled patients, the transition has been anything but smooth, forcing severely ill patients to give up their doctors, delay treatment and travel long distances for specialty care.<\/p>\n<p>As of this month, the state has transitioned 333,000 people, many with diseases such as multiple sclerosis, lupus and metastatic cancer. State health officials said managed care oversees all of the patients&#8217; treatment and guides them through the healthcare system, helping prevent unnecessary procedures and hospital visits.<\/p>\n<p>Patients could apply for temporary exemptions if they wanted to stay on a fee-for-service plan, where the state pays doctors based on the specific treatment provided instead of a managed care general rate that is usually less. But the patients had to meet a high bar: They had to be in ongoing care for a serious illness and any change could cause their condition to deteriorate.<\/p>\n<p>&#8220;The criteria is met by very few people,&#8221; said Susan McClair, senior medical consultant with the state Medi-Cal Managed Care Division.<\/p><\/blockquote>\n<p>One of the biggest issues with managed care continues to be access, as there simply aren&#8217;t enough providers that service managed care patients. The article goes on to report: <\/p>\n<blockquote><p>Shifting patients into managed care has been a &#8220;disruption&#8221; for many, in part because there simply aren&#8217;t enough specialists who will accept patients on Medi-Cal managed care, said Liz Forer, executive director of Venice Family Clinic. The patients&#8217; complicated illnesses overwhelmed family practice providers at Venice Family Clinic, Forer said. They weren&#8217;t equipped to treat patients with end-stage organ disease, multiple types of cancer or Parkinson&#8217;s disease.<\/p><\/blockquote>\n<p>Managed care is not the solution for California. To find out how you can help fight back against this broken system, please visit <a href=\"http:\/\/rxchoiceandaccess.com\">Pharmacy Choice and Access Now<\/a> today!<\/p>\n","protected":false},"excerpt":{"rendered":"<p>California approved moving patients enrolled in Medi-Cal, the state&#8217;s Medicaid program, to a managed care system last year, and the transition has been a rocky one for many California patients, according to an article in the <i>LA Times<\/i>. The purpose of the transition is to cut millions from the Medi-Cal budget to help the state&#8217;s rocky economy. A noble pursuit to be sure, but at what cost? If reforming Medi-Cal causes patients with disabilities, the elderly, and the chronically ill to lose access to the medical care they so desperately need, is it worth it? <\/p>\n<p>According to the <a href=\"http:\/\/www.latimes.com\/news\/local\/la-me-managedcare-disabled-20120702,0,7549313.story\">article<\/a>:<\/p>\n<blockquote><p>But for some of these low-income seniors and disabled patients, the transition has been anything but smooth, forcing severely ill patients to give up their doctors, delay treatment and travel long distances for specialty care.<\/p>\n<p>As of this month, the state has transitioned 333,000 people, many with diseases such as multiple sclerosis, lupus and metastatic cancer. State health officials said managed care oversees all of the patients&#8217; treatment and guides them through the healthcare system, helping prevent unnecessary procedures and hospital visits.<\/p>\n<p>Patients could apply for temporary exemptions if they wanted to stay on a fee-for-service plan, where the state pays doctors based on the specific treatment provided instead of a managed care general rate that is usually less. But the patients had to meet a high bar: They had to be in ongoing care for a serious illness and any change could cause their condition to deteriorate.<\/p>\n<p>&#8220;The criteria is met by very few people,&#8221; said Susan McClair, senior medical consultant with the state Medi-Cal Managed Care Division.<\/p><\/blockquote>\n","protected":false},"author":6330,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[],"tags":[],"class_list":["post-14442","post","type-post","status-publish","format-standard","hentry"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack-related-posts":[],"jetpack_shortlink":"https:\/\/wp.me\/p6Pvhz-3KW","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/calitics.com\/index.php\/wp-json\/wp\/v2\/posts\/14442","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/calitics.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/calitics.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/calitics.com\/index.php\/wp-json\/wp\/v2\/users\/6330"}],"replies":[{"embeddable":true,"href":"https:\/\/calitics.com\/index.php\/wp-json\/wp\/v2\/comments?post=14442"}],"version-history":[{"count":0,"href":"https:\/\/calitics.com\/index.php\/wp-json\/wp\/v2\/posts\/14442\/revisions"}],"wp:attachment":[{"href":"https:\/\/calitics.com\/index.php\/wp-json\/wp\/v2\/media?parent=14442"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/calitics.com\/index.php\/wp-json\/wp\/v2\/categories?post=14442"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/calitics.com\/index.php\/wp-json\/wp\/v2\/tags?post=14442"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}