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MEDI-CAL MANAGED CARE QUALITY INITIATIVE
Context
Greater state and national attention is being focused on not only the cost, but also the quality of healthcare. More than 21 million people in California are enrolled in a managed care plan, 5.7 million of whom are Medi-Cal recipients. Medi-Cal HMO enrollment is increasing significantly despite flat or declining HMO enrollment in other sectors. Monitoring the quality of care provided by Medi-Cal Managed Care (MCMC) plans is a task of critical importance for California and Medi-Cal consumers who rely on the healthcare system to provide quality care, including culturally and linguistically-appropriate services especially geared to children and families.

Goal
Improve the quality of healthcare provided to Medi-Cal Managed Care consumers through effective monitoring, greater public accountability, and community awareness.

Activities
This project is working to increase awareness and enhance involvement in healthcare quality issues among California's state agencies, consumer advocates, and Medi-Cal Managed Care consumers. Activities include examining the quality of care provided by MCMC plans based on the current measurement system and conducting a survey to identify the information gaps and needs of MCMC consumers. The project will explore strategies to address identified quality of care and information gaps, including examining how Medicaid programs across the country are using consumer report cards as part of their quality assurance systems. Community forums and issue briefs will bring attention to the gaps, explore strategies to address them, and make policy recommendations to improve the quality of care in Medi-Cal Managed Care.

By examining quality performance and consumer information needs, we hope to strengthen California's quality assurance system as well as identify consumers' informational needs in making good healthcare decisions. There are a number of other states that have made progress in publicly reporting quality information to consumers and driving improvements among health plans, and we look forward to California moving in that direction. CAROLINE RIVAS, PROJECT DIRECTOR

ALLIES FOR QUALITY: Patient and Consumer Groups Improving Health Care was developed by the California HealthCare Foundation's (CHCF) Quality Initiative to support and encourage patient and consumer groups' involvement in healthcare quality issues. CHCF is an independent philanthropy committed to improving California's healthcare delivery and financing systems. The Quality Initiative is a catalyst for improving the quality and accountability of healthcare in California through public reporting of performance measures and advancement of improvement.

For more information, contact Michelle Wood at 323.295.9372 x231 or michelle@chc-inc.org .





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