Complex Care in a Complex State: Lessons From California

The unique composition and massive size of California’s population means that health plans and systems in the state have had to explore new ways to improve the delivery of healthcare for those with complex health and social needs, according to panelists at the AHIP Institute & Expo 2018.

The session kicked off with some basic facts about California, where the conference was held: Its 39.5 million residents account for almost $400 billion in healthcare spending per year, and about one-third of those people are enrolled in Medi-Cal, the state’s low-income health coverage program. California has expanded Medi-Cal eligibility for adults under the Affordable Care Act and, separately, for undocumented immigrant children. Due to the fragmentation of care and separate funding streams in the state, there are considerable challenges in coordinating care for those with complex needs. (read more)