Medicaid Managed Care - U.S. Senate Special Committee on Aging

B- 27601
471
The Two-Plan Model California's managed care expansion program-often referred to as the
two-plan model-was designed to ensure that each of the two managed
care plans operating in each county could achieve an enrollment level
sufficient to spread risk and that beneficiaries could obtain care from
health plans that also served privately insured individuals. In addition, the
model was developed to make the most of limited state resources by
restricting the number of plans the state would need to monitor.
Selection of the 12 counties to use the two-plan model was made on the
basis of two criteria. 6 First, the counties must have had a minimum of
45,000 <strong>Medicaid</strong> beneficiaries eligible to participate in managed care,' and,
second, the counties must have had an interest in the program or a
significant managed care presence already established in the county. (See
table I for the number of eligibles and current enrollees by county and
plan.)
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