Supplemental Data for Medi-Cal Quality of Care and Access to Care
As discussed in Chapter 1, state law establishes access requirements to define the limitations to the times and distances Medi-Cal plans may require their beneficiaries to travel to obtain medical care. DHCS granted alternative access standards to the State’s health plans in the nearly 10,000 instances in which they collectively requested this form of waiver. More than 1,000 of these 10,000 instances were for the Regional Model health plans. Further, in more than 100 instances, DHCS granted an alternative access standard to one of the Regional Model health plans that required its beneficiaries to travel at least 100 miles farther than the distance another plan required its beneficiaries to travel in the same location for the same care. The animation below shows an example of one of these instances.
Additionally, as discussed in Chapter 1, the Regional Model health plans have not provided an acceptable quality of care to beneficiaries as shown in the percent of quality of care scores below the minimum performance levels set by DHCS. As the animation below shows, the plans in the Regional Model counties have delivered a lower quality of care to beneficiaries than any other model for the most recent years, 2017 and 2018.
Use the interactive graphics below to explore the maximum distances for alternative access standards and the percent of quality of care scores below the minimum performance level by year. Click the Access to Care and Quality of Care buttons to switch between graphics.
Source: Analysis of alternative access standards DHCS approved as of January 2019, and HEDIS quality of care scores.