Important Changes to Medi-Cal

As of July 1st, 2011, 16,000 Marin residents with full scope Medi-Cal will have a new managed care health plan: Partnership HealthPlan of California (PHC). Partnership is a non-profit health plan that provides Medi-Cal benefits to several California Counties including Solano, Yolo, Napa and Sonoma Counties.

Questions? Call Member Services Department (800) 863-4155 www.partnershiphp.org

Partnership members can expect to see the following improvements:

Specialty Medical Care - PHC has developed a network of specialty providers in Marin to serve Medi-Cal patients. Members should have improved access to specialty medical care.

Gaining a Medical Home - Each member will have a primary care provider and thus an established medical home. Members should see improved access to and easier navigation of the health care system. Additionally, PHC provides case management to members with multiple chronic health care conditions, who are transitioning from hospital to home with risk for readmissions, and with high risk pregnancies.

Monitoring Quality - PHC requires their providers to meet certain standards and monitors them. Additionally, providers are given a financial incentive to meet quality benchmarks such as preventative screenings, client satisfaction rates, and access to care.

Important Member Information
It is important to note that not all members will be assigned a primary care physician (PCP); the following Special Member categories are treated as exceptions:

• Share of Cost members
• 1st month eligible (if they have not picked a PCP)
• LTC patients
• Members that do not live in County
• Foster care placements
• Specific medical conditions
• Members with commercial health insurance coverage
• Member with Medicare (dual eligibles i.e. Medi-Medi).

Also, people with emergency Medi-Cal will not be enrolled in Partnership.

PHC has a multi-county governing board including representatives from both the member and provider communities. In Marin, the Board of Supervisors has appointed:

Community clinics representative Rafael Gomez, CEO of Coastal Health Alliance;

Hospital representative David Cox, CFO of Marin General Hospital; and

County representative Dr. Craig Lindquist, Medical Director, HHS Clinics.

Questions? Call Member Services Department (800) 863-4155 www.partnershiphp.org