CHA News Article

Report Examines Health Plan Investment in Safety Net Post-ACA

The California HealthCare Foundation (CHCF) has released a report that examines health plans’ investment in the safety net due to increased Medi-Cal enrollment under the Affordable Care Act (ACA). Titled Medi-Cal Win-Win: Surging Enrollment Fosters Investment in the Safety Net, the report outlines the policy and enrollment changes in 2013-15 that resulted in new relationships, opportunities and pressures for Medi-Cal managed care plans and safety-net clinics. In addition, the report documents health plan investments in the safety net and implications for the future.

According to the report:

  • Almost 70 percent of Medi-Cal beneficiaries were enrolled in public plans in 2015. Safety-net clinics now have 41 percent of beneficiaries enrolled in Medi-Cal plans, including 30.3 percent in community clinics and health centers (CCHCs) and 10.3 percent in county clinics.
  • Safety-net clinics accounted for 54 percent of new managed care members, post-ACA. Although the commercial plans also moved new members into these clinics, the public plans depended on them much more heavily, assigning almost 1.3 million new members to safety-net clinics in response to the expansion.
  • There is wide variation in safety-net clinics’ market share across type of clinic (county vs. CCHCs), type of health plan (commercial, local initiative, and county organized health system), geographic location (north vs. south) and Medi-Cal aid category (adult expansion, seniors and persons with disabilities, and other aid categories).
  • The high levels of Medi-Cal enrollment in public plans heighten the importance of quality data comparisons between commercial plans and public health plans.

A summary brief and the complete report are available on the CHCF website.