Review of Medi-Cal System
The California Medical Assistance Program (Medi-Cal) budget system focuses on low-income populations. Its costs are usually divided between the state and the government. It is expected that the government will cover 90 percent of costs by 2020. Medi-Cal contains the two types of payment such as Fee-For-Service (FFS) that implies individual payments and managed care that includes contract payments (“The 2015-16 Budget: Analysis of the health budget”, 2016). The caseload of the Medi-Cal budget system estimates approximately 11 million people, while its work is primarily based on the federal Patient Protection and Affordable Care Act (ACA). The report shows that there are several policy changes the implementation of which will require an extended period.
According to the governor’s projections, the caseload will be 12.2 million by 2016, while budget estimates will be 220, 000. Speaking of Los Angeles County (LAO) assessment, it is possible to note that the senior caseload is likely to be 2,3 percent more in 2016 that will increase the General Fund by a $ 95 million (“The 2015-16 Budget: Analysis of the health budget”, 2016). LAO assessment illustrates that the system budget will coincide with economic development. Uncertainty levels, however, will be greater than it was in the previous year, especially it relates to mandatory expansion estimates.
It should be emphasized here that families and children enrolled in the system in terms of ACA MAGI eligibility standards in 2014 showed mild growth rates and will be estimated according to post–ACA MAGI standards, thus integrating with those who were covered by Medi-Cal before ACA. In the context of the mentioned change, the California Department of Health Care Services (DHCS) proposes 65 percent of the caseload for mandatory expansion that, in its turn, leads to several implications. For example, the underlying trend can be decreased due to economic traction that will distinguish between families and children involved before ACA and those who were enrolled after its implementation. The designation of the mandatory expansion is likely to be eliminated from the system as both pre–ACA and post–ACA families and children are covered by the same policy.
Furthermore, the report provides some recommendations on how to enhance the caseload estimation. It is stated that monthly caseload reports made by administration are likely to contribute to keeping focused on current tendencies and making it possible to react immediately. Another recommendation is associated with the simplification of the procedures introduced by ACA. Even though it makes the collection of data easier, a certain extent of abstraction and misleading can be noted. Therefore, it is recommended to reconsider this policy.
Spending Allocations
From the above observations, it becomes evident that the anticipated budget is associated with trends from previous years. Various figures clearly show that budget allocations are made according to experience and economy trends. At the same time, the report explains the reasons for such spending allocations, pointing out that families and children enrolled in Medi-Cal were accurately analyzed to make the subsequent conclusion and forecast perspective changes (“Medi-Cal local assistance estimates”, 2016). If I could allocate spending differently, I would, perhaps, pay more attention to collecting information on the caseload estimate and children enrolled in the system. It seems that adolescents and children’s treatment receives insufficient budget and thus requires more in-depth analysis as well as the subsequent increase of their budgeting.
After reviewing the presented report, it is possible to note that it is quite sufficient to make future assumptions. In particular, the report identifies both actual and estimated costs from previous years and provides convincing arguments that may serve as a basis for forecasting future trends in Medi-Cal. However, it will be better if the report included some detailed information on the mandatory expansion and underlying trends as these aspects seem to be revealed superficially.
Significance of Report
In my opinion, the variance related to post-ACA patients is the most important one. According to the anticipated estimates, their number will grow due to the implemented federal reform that may reflect on budget. In particular, approximately two million people are to be involved in Medi-Cal in 2015 as a result of the program expansion. In general, the governor’s caseload projections seem to be appropriate and reasonable as they are based on the changes that occurred since the previous year. However, ACA changes make it much more difficult to predict the potential of the caseload in the future. This is caused by the fact that they are unlikely to appear again, being replaced by economy-related trends (“Medi-Cal and the governor’s proposed 2015-16 budget: Health care reform boosts enrollment and federal funding”, 2015). Therefore, I agree with the governor that it is essential to pay attention to these changes as well as to uncertainty factors to reveal their impact on Medi–Cal budget. The budget proposed by LAO also seems to be relevant and comprehensive. Focusing on the most valuable points, it estimates and anticipates several trends. The fact that this evaluation is also based on the previous years and credible data proves its reliability.
References
Medi-Cal and the governor’s proposed 2015-16 budget: Health care reform boosts enrollment and federal funding. (2015). Web.