Providers raise concerns over California's value-based Medicaid reforms

Providers are concerned that California's value-based Medicaid reforms are not reaching the patients who need help most, according to a Kaiser Health News report published Oct. 10 in The Los Angeles Times.

CalAIM, a $9 billion, five-year initiative, provides patients with nonmedical benefits and is designed to keep patients out of emergency departments, jails, nursing homes and mental health crisis centers. 

So far, 97,200 patients out of 14.7 million Medi-Cal recipients are enrolled in the CalAIM program, Kaiser Health News reported. 

While these benefits are important, providers say, they aren't reaching enough recipients, and providers are still not reimbursed enough through the state's Medicaid program. 

Elaine Batchlor, MD, CEO of Martin Luther King Community Hospital in Los Angeles, has lobbied California Gov. Gavin Newsom and state lawmakers to increase payments for providers treating Medicaid patients. 

Mr. Newsom vetoed a bill in September that would have increased Medicaid payment rates.  

"The state is now saying it will allow Medicaid dollars to be spent on things like housing and nutritious food — and those things are really important — but they're still not willing to pay for medical care," Dr. Batchlor told Kaiser Health News. 

Read the full report here. 

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