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OCMA Blog

OCMA Member Update on Dual Eligibles Demonstration Project

February 25, 2013

 

Over the last 8 months as CalOptima has been building the foundation for the duals demonstration in Orange County, the OCMA has worked consistently and diligently to represent the interests of physicians and their patients.  The critical decision during this early stage of the demonstration was CalOptima board approval of a health care delivery system to serve the duals patients.

Click here for detailed background information.

 

The OCMA strongly advocated that individual physicians, currently serving the duals patients, be included in the delivery system.  A number of these physicians see their duals patients through Medicare Fee-for-Service, and it is important that duals patients continue to have access to their current physicians.

 

OCMA sent a letter to the CalOptima CEO outlining the reasons for the individual contract option.  This letter is the culmination of months of work and summarizes the many points we carried to individual CalOptima board members and their senior staff.  

Click here for the letter to sent to the CalOptima CEO on behalf of OCMA. 

 

We are very pleased to inform our members that the CalOptima board approved a health care delivery system that will include the individual physicians.  At the February meeting of the board, they considered a number of options and, in the end, agreed to develop a network model that will offer an individual contract option to physicians.  

Click here for the approved actions that were passed by the CalOptima board.

 

There remain a number of other important decisions relative to the duals demonstration, but we have achieved the major milestone noted above.  The OCMA will continue to be an active participant in the duals demonstration, decision-making processes and will continue to update the membership as we reach other critical decision points.


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