On March 28 the California HealthCare Foundation (CHCF), a nonprofit philanthropic organization, released the results of a survey of some 1500 randomly selected beneficiaries who were part of the Medi-Cal SPD transition last year.  The survey was seeking input as to how the Medi-Cal program can improve the transition process for the upcoming Medi/Medi transition beginning late this year. 

CAMPS Executive Director, Bob Achermann, accessed the slides and listened to a webcast that reviewed of the findings and provided comments from a couple of patient advocacy groups on the findings. There were multiple references to DME/supplies that were very positive to our quest to have more providers in the networks and the importance to these patients.  Following are few facts/findings from the CHCF survey;

• (1)  Plan navigation - Q: Do you know how to access services? Responses:  only 57% knew how to get DME/supplies compared with 90% who know how to get an Rx filled.
• (2)   The survey resulted in identifying key areas for more beneficiary education & support one of which was "assistance w/ authorization process for specialists, medical equip./supplies, and prescriptions."
• (3)    When beneficiaries were asked, "Are your benefits different in managed care?"  32% of the respondents indicated that they were worse. The responses indicated that the third worse, at 19% was DME/supplies.
• (4)    When asked about out of pocket expenses 62% indicated that the transition did not affect their out of pocket expenses; however, 19% indicated an increase in expenses and identified DME/supplies and DME repairs as a source.
• (5)    DME/supplies- 37% reported using, 28% said they switched suppliers because of the transition- on the question of access 26% indicated that access was more difficult, 47% indicated access was about the same.

An attorney with Disability Rights Network made a specific comment about "continuity of care" suggesting that DHCS should have included DME/medical supply providers in that provider category.  The CHCF report and the patient advocate groups support are both very positive for CAMPS efforts to expand plan networks.

You can view the briefing slides at http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/S/PDF%20Sacto03282013SPDsTransitionMediCalManagedCare.pdf.

Also, a first look study was conducted by the CHCF and published in August 2012, which reveals some interesting facts and recommendations.   

Click here to access that report, http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/F/PDF%20FirstLookMandatoryEnrollmentSPD.pdf.