Health Plan Weekly

More employers are looking at offering near-site or onsite health clinics to employees and their families, in a bid to improve employee retention, elevate quality of care and better manage medical and pharmacy costs. To optimize these clinic offerings, employers should incorporate high-performing providers and align incentives between patients and primary care physicians (PCPs), say experts who spoke at a recent conference held by the Business Health Care Group (BHCG) of Wisconsin. 

According to Mercer’s “Health & Benefit Strategies for 2023” report (see infographic), 17% of large employers said they currently provide onsite or near-site health services to employees, while 12% are planning or considering doing so. The survey was conducted April 26 to May 13, 2022, and included 451 organizations with 500 or more employees. 

California elected officials approved a controversial plan that will enroll members of Medi-Cal, the state’s Medicaid program, in Kaiser Permanente’s MCO — shifting those same enrollees off the books of the insurers that currently claim them as members. That’s despite the vociferous objections of 16 county-run MCO plans, which stand to lose hundreds of thousands of members in the transfer to Kaiser Permanente, according to the CEO of the largest plan involved. 

Kaiser Permanente did not have to participate in the normal Medi-Cal MCO bidding process to strike the deal. Instead, the integrated health system and insurer, which is based in Oakland, worked directly with the office of Democratic Gov. Gavin Newsom to develop a bill, Assembly Bill No. 2724 (A.B. 2724), authorizing the no-bid contract. State legislators approved the bill on June 29, with the lower chamber, the Assembly, voting 48-15 in favor and the Senate approving the deal 25-7. 

By no later than 2024, California will allow residents aged 26-50 with any immigration status to enroll in Medi-Cal, the state’s Medicaid program — making the state the first in the nation to allow all undocumented residents to enroll in safety-net insurance programs. State officials estimate that Medi-Cal enrollment statewide could grow by more than 700,000 as a result of the expansion, and follows a similar move last year to expand Medi-Cal eligibility to undocumented Californians aged 50 and over, a cohort of about 185,000 people, according to the office of Democratic Gov. Gavin Newsom. 

That enrollment surge will likely come at the same time as state agencies and managed care organizations wind down record Medicaid enrollment backed by pandemic relief funds and the national suspension of eligibility redeterminations required by the federal pandemic response measures. The CEO of the state’s largest MCO, L.A. Care, tells AIS Health, a division of MMIT, that the insurer is staffing up to address the administrative challenges — and said the expansion should improve health outcomes for a group of residents who are underserved and disadvantaged by the current setup.