Providing affordable, patient-centered care is the most effective way to provide high-quality care to Californians through early diagnosis of chronic conditions, access to appropriate treatment, and improved care management. Effective treatment and prevention of chronic conditions require access to affordable and integrated health care — and having continued access to trusted providers and health care plans is a key part of that.
However, a new policy from the California Department of Health Care Services is threatening to bring uncertainty and disruption to hundreds of thousands of San Diego County residents’ health care. The new policy would reduce the number of managed care plans in San Diego County from seven to only two.
This policy change was made without input from health advocates, county health officials, and medical professionals who are charged with keeping Californians healthy, and it could have a disastrous effect on the health of San Diegans living with chronic conditions.
Steady health care coverage and continuity of care is critical to prevent and effectively manage chronic conditions. Yet, by reducing the number of health care plans in San Diego County from seven to just two, California would needlessly force hundreds of thousands Medi-Cal beneficiaries to switch plans and potentially lose their primary care or specialist providers.
And it wouldn’t just hurt the over 700,000 people who are currently enrolled in Medi-Cal, but it would impact the health care choices of the over 900,000 San Diego County residents who are eligible. Many patients with chronic conditions have been building relationships and trust with their providers for years, formulating individualized treatment plans and building chronic disease prevention practices into their daily lives, and we need to prioritize these relationships that keep our neighbors healthy.
In addition to losing access to providers, forcing individuals off their current health care plans will have significant impacts on other care management benefits like transportation to and from appointments, 24/7 health care hotlines, and assistance with housing and food support — just to name a few. Many Californians with chronic conditions — especially people of color and those with low education attainment and/or family income — rely on these care benefits to manage their health.
For instance, Black individuals in San Diego have the highest instances of heart disease, and managed care providers offer well-rounded, integrated care to treat and manage this chronic condition. Losing access to the care team and benefits that a patient is used to could result in inadequate care and lead to deeper health inequities in San Diego’s most vulnerable communities.
This decision would also bring even more uncertainty to a health care system that has been upended due to the COVID-19 pandemic, which disproportionately impacted Black and Latino Californians — deepening the health inequities and economic hardships that many Medi-Cal patients face. And as the delta variant creates new complications and health care officials navigate the lasting impacts of COVID-19, patients need stability and certainty in their care.
Removing access to the health care plans that currently serve San Diego County could also have a significant impact on costs. Forcing chronic care patients to suddenly change providers would result in discontinuity of care, which would negatively impact their treatment plans and increase costs. Additionally, reducing the number of available health care plans will remove significant competition — potentially raising costs for both the state and patients.
As the Department of Health Care Services finalizes decisions for Medi-Cal managed care providers, we urge San Diego County leaders to call on the state to rescind this new policy and ensure patients, providers, and caretakers can make their voices heard. Access to affordable, stable health care is a key component of managing chronic conditions and living a healthy, well-rounded life, and on the heels of a global pandemic, the decision by the state to significantly reduce the number of health care plans in San Diego County would needlessly harm the constituents they’re charged to serve.
Scott Suckow has more than two decades of experience working with the nation’s leading voluntary health organizations focused on different health conditions. He is the chair of the California Chronic Care Coalition in San Diego County.