Truong: California needs to improve health plan choices

I am honored to join the San José Spotlight team as the new business opinion columnist. As a longtime resident of San Jose and having been involved in the local business community for the past eight years, I hope to share some interesting perspectives on business issues through this post.

In 2019, I shared my personal experiences with San José Spotlight about my family’s small business and how they often had to choose between paying the mortgage or healthcare. As minorities and political refugees, my parents created their own opportunities by starting a small retail business. This often meant working at least 12-hour days and traveling long distances to Southern California to buy wholesale products for the company.

Unfortunately, my story is not unique, and I believe that many minorities have had to sacrifice their health to survive in America. Without California’s Medi-Cal system, my dad wouldn’t have lived this long after we found out he had stage four kidney cancer. That’s why I passionately and closely follow the future of Medi-Cal services in the state.

Currently, depending on the county you live in, Medi-Cal beneficiaries can choose between a county-administered plan or a commercial plan provider. More health plan choices provide more quality care options for Californians most in need.

On February 9, the California Department of Health Care Services (DHCS) unveiled a public bidding process for commercial health plans to provide health care services under the provision of health plans. Medi-Cal managed care. This is particularly notable as this was California’s first statewide purchase. Some of the procurement targets reported by the DHCS were:

  1. Increase transparency
  2. Responsibility
  3. Health Equity
  4. Quality
  5. Local involvement

Despite these stated goals of improving the quality of care and outcomes for Medi-Cal beneficiaries, DHCS has announced its intention to award Medi-Cal contracts to the same for-profit companies that are currently under contract throughout the state. What’s worse is that the procurement process favored for-profit companies with lower quality scores and rewarded the same plans with lower performance.

The hope was that the bid would take into account the communities served by the Medi-Cal program, but the decision placed little or no value on a strong local presence or ties to local community organizations. Based on the documents released so far, it is unclear whether the State Department has corroborated the applicants’ backgrounds, verified their claims and commitments, or checked in with community leaders who are deeply invested in the program. In a progressive state that values ​​community, shockingly, nonprofit applicants have been completely excluded, despite their deep roots in the state and in our neighborhoods.

I’ve seen firsthand the investments and the kind of community engagement that will benefit Santa Clara County and others across the state. Not only must our Medi-Cal plans provide high-quality care, but they must also address the social determinants of health by building permanent housing for those without homes, such as through the Homekey project, and by supporting hyperlocal non-profit organizations.

I hope California doesn’t limit fair competition in favor of administrative ease to manage a handful of commercial health plans. How would this decision have helped people like my father? It may be too late to get better care for my dad, but it’s not too late to demand better health care options for future generations who deserve better.

Governor Gavin Newsom should do the right thing and call for an overhaul of the Medi-Cal contract process to allow more local nonprofit health plans to participate.

San Jose Spotlight columnist Eddie Truong is director of DT Strategies, a San Jose-based business consulting firm, and co-founder of the Silicon Valley Restaurant Association. His columns appear every second Wednesday of the month.

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