Santa Clara County is pushing for a transition to a 'single plan' model for Medi-Cal managed care to improve reimbursement rates. This move has prompted resistance from the Santa Clara Family Health Plan, which has filed a lawsuit claiming it a 'hostile takeover.' The county aims to enhance efficiency and stability in Medi-Cal services by replacing the existing Family Health Plan board with county employees. Despite concerns about fiscal and liability issues that led to the formation of the separate entity in 1995, county officials believe they can better serve low-income residents by consolidating the structure.
County Executive James Williams emphasizes the urgent need for a unified Medi-Cal strategy to enhance the stability of California's critical safety net services, including community clinics.
The separation of the Family Health Plan from the county has created 'significant structural challenges,' complicating the ability to maximize revenue for local healthcare systems.
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