L.A. County among 4 picked for Medi-Cal managed care project

Los Angeles County was selected as one of four California counties to take part in a healthcare project that officials said will save money and improve care for some of the state's most vulnerable patients. 

The state Department of Health Care Services announced Wednesday that Los Angeles, Orange, San Diego and San Mateo counties were chosen to participate in a three-year project to shift hundreds of thousands of patients who receive Medi-Cal and Medicare into managed care.

State officials said they eventually plan to expand into six additional counties -- San Bernardino, Riverside, Santa Clara, Contra Costa, Alameda and Sacramento. About 750,000 of the state's 1.1 million "dual eligibles" live in those 10 counties.

In Los Angeles, the health plans responsible for the patient care coordination are L.A. Care and Health Net.The state plans to begin notifying patients in the fall and enrollment will begin in January, pending approval from the federal government.

Officials estimate the move to managed care will save the state $679 million in fiscal year 2012-13 and $1 billion the following year.

Under managed care, patients will be assigned to one health plan, which will be responsible for coordinating all of their care. That will create better results for patients, said Toby Douglas, director of the Department of Health Care Services.

"We expect that this demonstration will really improve the focus on the patient, over time reducing costs and improving outcomes," he said.

But advocates worry that the state is moving too quickly and that patients could suffer. Among the top concerns is that patients could lose access to their doctors.

"If this isn't working, how are we going to know that and what are we going to do about it?" said Deborah Doctor, legislative advocate with Disability Rights California. "There needs to be a pause button here."

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-- Anna Gorman

@annagorman

Photo: Bertha Poole navigates the kitchen of her Long Beach apartment, where she lives alone. Patients like Poole are eligible for Medicare and Medi-Cal, but are vulnerable to gaps in treatment, experts say. Credit: Robert Gauthier / Los Angeles Times