CMS Approves California’s Medicaid Plan


CMS has approved California’s Medicaid waiver request, which will allow the state to continue modernizing the Medicaid system and pay for uncompensated care.

California’s Medi-Cal system is pursuing a reform plan on four fronts. Included in the waiver are approvals for up to $3.7 billion in performance incentives for public hospitals; $1.5 billion over five years for a Whole Person Care pilot; $1.4 billion for the Global Payment Program Pilot, and unspecified funding for dental care reform.

The Whole Person Care pilot is aimed at patient populations that are heavy users of the healthcare system and often use emergency rooms for care. The Global Payment Program pilot supports the transition to outcomes based payment and care.

The waiver will also allow the state to support adult care programs and build coordinated care plans. California is also one of a handful of states that accesses federal funding for the care of uninsured individuals who can’t pay their hospital bills, that access will continue through this waiver.

All told California is getting some $6.2 billion in program support from the federal government through the waiver. The waiver went into effect on January 1.

Full text of the waiver is available here.