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L.A. Care Health Plan

L.A. Care Health Plan. Providers and Cal MediConnect Paul Van Duine Senior Director of Provider Network Operations. www.calmediconnectla.org. L.A. Care’ s Provider Network Strategy. Network Subcontracted health plans (similar to our current Medi -Cal model) Care1 st Health Plan

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L.A. Care Health Plan

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  1. L.A. Care Health Plan Providers and Cal MediConnect Paul Van Duine Senior Director of Provider Network Operations www.calmediconnectla.org

  2. L.A. Care’s Provider Network Strategy Network • Subcontracted health plans (similar to our current Medi-Cal model) • Care1st Health Plan • CareMore • Kaiser Permanente • IPAs with the capacity and expertise to serve this population • LA County Department of Health Services and community clinics • Hospitals, DME, and pharmacies experienced in serving this population • Long-Term Services and Supports (LTSS) providers • Mix of groups: small, large, Medi-Cal, safety net, commercial • IPAs and Medical Groups with a strong hospital affiliation Contracting • Predominantly shared risk model • IPA capitation • Facility DRGs • C-CAP potentially in the future to align risk between plan, IPA, and hospital

  3. Delegation Model (DRAFT)

  4. Timeline (Subject to Change) More information to come from DHCS regarding the MLTSS portion of the CCI.

  5. For the Latest Information www.calmediconnectla.org

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