California | Fall | 2008 | Health Plan Analysis
The consumer-driven health plan movement is undergoing a shakeup in California with health plans passing along double-digit rate increases for renewing customers to make up for losses on the high-deductible designs with rich preventive benefits. Meanwhile, brokers believe there is some evidence CDHPs are beginning to gain more traction in a state known for its acceptance of the capitated HMO model. Medicare special needs plans are due for a shake-up following the passage of new legislation that requires SNPs to implement an evidence-based model of care with appropriate networks of providers. The new law is of special significance in California, which is home to the second-largest enrollment in SNPs. Plans in the Medi-Cal program will see only a 1 percent cut in reimbursement following passage of a new law signed by Gov. Arnold Schwarzenegger. At the same time, health plans avoided legislation that would have required them to spend at least 85 percent of their premium dollars on direct medical care. Aetna has become the latest major health plan in California to offer members access to a provider network in Mexico. And Blue Shield of California is proposing a group Medicare Advantage plan for CalPERS members.
