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Medicaid Managed Health Plans

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A Medi-Cal Managed Care Health Plan contracts with specific doctors, clinics, specialists, pharmacies, and hospitals. These providers make up the health plan’s “network. In 1972 and 1975, Legislation enacted a law allowing the State of California to license the Health Maintenance Organization (HMO) to enrolled Medical beneficiaries. It wasn’t till 1990 that California decided to enrolled Medical beneficiaries into managed care. Today, more that 50 percent of Medical beneficiaries are enroll in a managed care. California has four Medicaid Managed Care (MMC) models; County Organized Health Systems (COHS), Geographic Managed Care (GMC), the Two-Plan Model and the Primary Care Case Management (PCCM) that enroll Medical beneficiaries on a prepaid basis. Beneficiaries enjoy a no-plan premium with all their covered services. MEDICAID ADVANTAGE PLAN AND MEDICAID MANAGED CARE 3 Introduction In 1972 and 1975, Legislation enacted a law allowing the State of California to license the Health Maintenance Organization (HMO) to enrolled Medical beneficiaries. It wasn’t till 1990 that California decided to enrolled Medical beneficiaries into managed care. Today, more that 50 percent of Medical beneficiaries are enroll in a managed care. California has four Medicaid Managed Care (MMC) models; County Organized Health Systems (COHS), Geographic Managed Care (GMC), and the Two-Plan Model and the Primary Care Case Management (PCCM) that enroll Medical beneficiaries on a prepaid basis. Medicaid Managed Care Enrollment Rate in the State of California Enrollment rate as of July 2010 The Medicaid managed care penetration rates, expansion enrollment by state, and the national penetration rate are composed annually by the Data and System Group (DSG) of the Centers for Medicare & Medicaid Services (CMS).
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