Report 2022-502 Recommendation 1 Responses

Report 2022-502: Follow-Up: Children in Medi‑Cal: The Department of Health Care Services Is Still Not Doing Enough to Ensure That Children in Medi‑Cal Receive Preventive Health Services (Release Date: September 2022)

Recommendation #1 To: Health Care Services, Department of

To help increase utilization rates, DHCS should begin to monitor and identify effective incentive programs at the health plan level and share the results with all plans.

6-Month Agency Response

The 2022 report was discussed and shared in the October 13, 2022 quarterly CMO Meeting. Attached is the slide deck presentation (Attachment 5) and the final report (Attachment 6) which was shared with the plans. The report illustrates the differences and potential impacts of alternative payment methods offered by the plans during the first two years of data collection. The discussion in the October call highlighted the notable differences and best practices. As noted, the reports for future years will be completed and shared in a similar manner on an annual basis going forward.

DHCS requests CSA deem the recommendation fully implemented. DHCS acknowledges CSA previously provided a perspective on implementation status referencing "a new incentive program in 2023." The Health Equity and Practice Transformation Payments program is under development, but DHCS highlighted the program for information only. The program is not a health plan-established incentive program at the health plan level and is unrelated to the implementation of the recommendation.

California State Auditor's Assessment of 6-Month Status: Fully Implemented

DHCS identified effective incentive programs at the health plan level and shared the results with all plans.

60-Day Agency Response

There has been no change since the previous implementation plan from the draft report response submitted to CSA on 08/26/22.

California State Auditor's Assessment of 60-Day Status: Pending

Although DHCS asserts in its response that it implemented our recommendation in July 2022, the information it shared with the health plans during this time lacked sufficient detail about identified best practices for incentive programs to be useful. Further, as it indicated in its original response to the audit report, DHCS planned to share additional information with the health plans in October 2022 and plans to launch a new incentive program in 2023. Therefore, DHCS's implementation of this recommendation will not occur until sometime in 2023.

All Recommendations in 2022-502

Agency responses received are posted verbatim.