• Gryphon Login
  • MyCourses
  • Alumni
  • UCLA Health
  • Contact Us
Prospective Students

Prospective Students

Prospective Students
  • Admissions
    Procedure & Timelines
    • Admissions Timeline
    • Admissions Procedure
    • Basis of Selection
    • COVID-19 Impacts on Admissions
    • Housing Information
    • Interview Process
    • Prerequisites
    General Information
    • Statement of Diversity
    • Mission Statement
    • Curriculum Resdesign
    • Honor Code
    • FAQs
    • Admissions Brochure
    • Admissions Timeline
    • Admission Procedure
    • Basis of Selection
    • Competencies
    • COVID-19 Impact on Admissions
    • DACA Applicants
    • DGSOM Mission Statement
    • FAQs
    • Honor Code
    • Housing Information
    • Interview Process
    • Statement of Diversity
    • Virtual Events
  • Outreach & Pipeline Programs
    Summer Pre-Health and Postbaccaluareate Programs
    • UCLA SHPEP
    • UCLA PREP
    • UCLA RAP
    Outreach and Recruitment
    • Conferences and Events
    • Stay Connected!
    • Contact Us
    • Conferences & Outreach Events
    • Summer Pre-Health and Postbaccalaureate Programs
    • Contact Us
    • Stay Connected
  • Financial Aid & Scholarships
  • Degrees & Programs
  • Curriculum
  • Student Life
    Why Choose UCLA
    • Research
    • Clinical Work
    • Service Opportunities
    • Global Health Impact
    • Why You'll Love LA
    Campus Life
    • Student Organizations
    • Annual Events
    • Day in the Life
    • Around Campus
    • Photo Galleries
    • Medical and Research News
    • Medical Student Council
    • Geffy Guide
    • Search Campus and Health News
    • Service Opportunities
    • Global Health Impact
    • Why You'll Love LA
    • Photo Galleries
    • Day in the Life
    • Around Campus
    • Medical and Research News
    • Search Campus and Health News
  • How to Apply
  • Gryphon Login
  • MyCourses
  • Alumni
  • UCLA Health
  • Contact Us

Prospective Students

Search Campus and Health News

Search Campus and Health News

Search Campus and Health News

  • Health News
  • A Day in the Life
  • Around Campus
  • Medical and Research News
  • Health News
  • A Day in the Life
  • Around Campus
  • Medical and Research News
  1. Home
  2. Prospective Students
  3. Student Life
  4. Search Campus and Health News

Search Campus and Health News

Share this

Health News

Title

UCLA report shows frail Angelenos reject managed health program

Health News

Date
09/27/2017
Article

Three in five of the poorest, sickest residents in Los Angeles County have rejected a managed health care program meant to improve their access to health services, according to a policy brief by the UCLA Center for Health Policy Research. As a result, the county’s opt-out rate for the program is the highest in California, pushing overall enrollment far lower than expected.

The managed care program, called Cal MediConnect, was designed to integrate financing and delivery of medical, mental health and other health care services for 415,000 medically frail elderly or severely disabled young Californians who qualify for both Medicare and Medi-Cal benefits in the seven-county pilot program area. Eventually, 1.1 million Californians could be enrolled.

The main goal of Cal MediConnect is to have one entity coordinate care for this high-need, high-cost group, which eliminates fragmentation of health services and subsequent gaps in care, according to the policy brief. The new program also provides extra benefits, such as unlimited transportation and more vision and dental care.

However, as of July 1, just 19 percent of eligible people in L.A. County were enrolled — 38,020 people out of about 200,100. Although the California Department of Health Care Services in 2014 projected a enrollment rate of more than 60 percent in the seven participating counties in the state, the rate is less than half that at 28 percent, the brief reports.

Factors that contributed to opt-outs in L.A. County

According to the UCLA study, the possibility of losing a trusted doctor is enough to prompt many in L.A. County to opt out of the new program, which automatically enrolled people who were eligible.

“These are very vulnerable people who have worked long and hard to cobble together a network of doctors and specialists they trust,” said Kathryn Kietzman, a research scientist at the UCLA Center for Health Policy Research and co-author of the policy brief.  “They don’t want to lose that.”

Kietzman and co-authors conducted 53 one-on-one interviews and six focus groups with an additional three dozen L.A. County residents who are eligible for both Medicare and Medi-Cal.

They found that many consumers were confused about whether benefits under the new program were better or worse than what their two current programs offered, contributing to the growing rejection rate, according to the brief. Some consumers — including those with significant language barriers —were overwhelmed by an avalanche of information they didn’t understand. Certain ethnic and racial groups had especially high opt-out rates, including 94 percent of Russian speakers, 79 percent of Koreans, and 72 percent of Amerasians, Chinese and whites.

Latinos/Hispanics were among the least likely to opt out (45 percent), second only to Samoans (36 percent).

“People often went by word of mouth — from friends, family, their current doctors — to decide whether to remain enrolled,” said Kate McBride, graduate student researcher at the center and lead author of the policy brief. “’But the information from those sources wasn’t always accurate.”

Recommendations

Authors of the brief suggest policies to ensure these vulnerable consumers and their families make informed decisions about their health care, including:

  • Have people help review and disseminate the health care information. Current consumers and their families can help make sure future informational materials are in simple, understandable language and translated into multiple languages and formats — print, in-person talks and web-based materials. Also, consumers’ families, doctors, community advocates and others could be trained as health information navigators for those with limited health literacy, similar to Covered California’s Navigator Program.
  • Avoid disruption of a someone’s existing network of health care. Losing access to trusted health providers is the biggest concern of consumers who are eligible for both Medicare and Medi-Cal. State policymakers and planners could propose a new model that coordinates care across existing programs. Then consumers could choose to keep their existing Medicare and Medi-Cal providers if they wish but also access new program services they lack. Washington State’s managed fee-for-service program is an example of this type of model.
  • Recognize and respond to consumer diversity. Language proficiency, education, immigration status and other factors complicate decision-making about new health care plans. Community organizations must identify and address the different needs and challenges facing these people in L.A. County and help them through the decision-making process.

This policy brief is based on findings from a two-year study of how L.A. County residents eligible for Cal MediConnect made their decisions, conducted by the UCLA Center for Health Policy Research in partnership with the Westside Center for Independent Living and a community advisory group of five consumers and five stakeholders. The policy brief was developed with support from the Robert Wood Johnson Foundation.

Like Us on Facebook Follow Us on Twitter Subscribe to Our Videos on YouTube Follow us on Instagram Connect with Us on LinkedIn Follow us on Pinterest Follow us on Flickr Follow us on Sharecare
Top 10 U.S. Medical Schools
  • Giving
  • Publications
  • Newsroom
  • Weekly Digest
  • Directory
  • Contact Us
  • Diversity
  • Emergency
  • Maps & Directions
  • UC Regents
  • Abuse Free
  • Volunteer
  • Biomed Library
  • Disability Resources
  • UCLA Health
  • Smoke-Free
  • Sitemap
  • Terms of Use
Top 10 U.S. Medical Schools
Like Us on Facebook Follow Us on Twitter Subscribe to Our Videos on YouTube Follow us on Instagram Connect with Us on LinkedIn Follow us on Pinterest Follow us on Flickr Follow us on Sharecare