California’s Medicaid Program Fails To Ensure Access To Doctors

Long waits and lack of access to doctors is a continuing problem with California's Medicaid program, an audit finds.

Long waits and lack of access to doctors is a continuing problem with California’s Medicaid program, an audit finds.

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Terri Anderson signed up for California’s Medicaid program earlier this year, hoping she’d finally get treatment for her high blood pressure. But the insurer operating her Medicaid plan assigned the 57-year-old to a doctor across town from her Riverside, Calif., home and she couldn’t get there.

“It was just too far away,” says Anderson, adding that she cares for her 90-year-old ill father and can’t leave him alone to make an hour round-trip drive to the doctor. Now she’s crossing her fingers that a health clinic near her house will accept her new insurance.

She’s not alone. In an effort to control costs in its rapidly expanding Medi-Cal program, California has relied heavily on managed care insurance companies to treat patients like Anderson.

The state pays insurers a fixed amount per enrollee and expects the companies to provide access to doctors and comprehensive care. But a scathing state audit released last Tuesday shows that California is failing to make sure those plans deliver. Many enrollees have insurance cards but often have trouble getting in to see a doctor.

The state didn’t verify that insurers’ directories of doctors were accurate,

Article source: http://www.npr.org/sections/health-shots/2015/06/22/416467076/californias-medicaid-program-fails-to-ensure-access-to-doctors?utm_medium=RSS&utm_campaign=affordablecareact

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