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LOW MEDI-CAL RATES LIMIT BENEFICIARY ACCESS Counties Providing Medi-Cal Home Health Visits Counties with 2-10 HHAs Butte, Contra Costa, El Dorado, Humboldt, Counties with one HHA Imperial, Kern, Kings, Lake, Amador, Calaveras, Colusa, Del Mendocino, Merced, Monterey, Napa, Norte, Inyo, Lassen, Madera, Nevada, Placer, Plumas, San Francisco, Marin, Mariposa, San Benito, San Joaquin, San Luis Obispo, San Solano, Trinity, Yolo, (13) Mateo, Santa Barbara, Santa Clara, 31 Counties Santa Cruz, Shasta, Sonoma, Siskiyou, Stanislaus, Sutter, Tehama, Tulare, Tuolumne (31) 13 Counties Counties with 11-20 HHAs Alameda, Fresno, Orange, Sacramento, Ventura (5) Counties with zero HHAs 6 Counties 5 Counties Alpine, Glenn, Modoc, Mono, Sierra, Yuba (6) 1 3 Counties with 21-99 HHAs Riverside, San Bernadino, San Diego (3) Counties with 100+ HHAs Los Angeles (1) Key Facts: There are 715 HHAs in California that are Certified to provide Medi-Cal services. Only 546 of these actually provided any Medi-Cal services in 2005. There is an important distinction between the number of Medi-Cal agencies that certified to provide care, and the number of agencies that actually do provide care. There are 6 coutnies where no Medi-Cal home health agency visits were provided in 2005. There are additionally 13 other counties where there is only one provider of Medi-Cal Home Health Agencies. Over half of all home health agencies limit there services to one hundred or less Medi-Cal visits per year. Page 5 LIMITED MEDI-CAL BENEFICIARY ACCESS TO HOME HEALTH SERVICES ALL Home Health Visits (N=9,408,280) by Source of Payment Medi-Cal, 7.50% Medicare, 70.00% Other Third Party, 6.60% Other Sources, 15.80% Key Facts: Even though 82% of all Home Health Agencies in California are Medi-Cal certified, only 7.5% of HHA payment sources are Medi-Cal; A CAHSAH survey of discharge planners and home health agencies in five counties (Los Angeles, Sacramento, Monterey, San Francisco, and Butte) in Fall 2006 revealed that low reimbursement rates and lack of nurses were key factors that limited the census of Medi-Cal patients for home health agencies. Nineteen home health agencies (2% of all agencies) from the five sampled counties (Los Angeles, Sacramento, Monterey, San Francisco, and Butte) indicated that they collectively deny 93 patients per month. Extrapolated across the state, 4,185 patients are denied monthly and 50,220 patients are denied per year. LOW MEDI-CAL RATES LIMIT BENEFICIARY ACCESS Home Health Agencies and Medi-Cal Visits as Percent of Total Visits (Home Health Agencies N=860, Total Medi-Cal Visits N=977,170) Home Health Agencies that Home Health Agencies that provided 5% to 25% of their provided 25% or more of their total Visits as Medi-Cal Visits, total visits as Medi-Cal Visits, 56 154 18% 6% Home Health Agencies that are NOT Medi-Cal Certified, 145 17% 36% Home Health Agencies that provided less than 5% of their total Visits as Medi-Cal Visits, 23% 310 Home Health Agencies that are Medi-Cal Certified, but provided NO Medi-Cal Visits, 204 Key Facts: Most agencies provide very few home health visits to Medi-Cal beneficiaries and elect to provide services to Medicare beneficiaries, private pay and health insurance beneficiaries. Forty percent of all home health agencies in California do not provide any home health Medi-Cal visits, and more than half (52%) of all home health agencies certified to provide Medi-Cal visits, provided less than 75 Medi-Cal visits in 2005. Onlt a few agencies are providing most of the Medi-Cal visits. Just under one quarter (24%) of all home health agencies in California had 5 percent or more Medi-Cal visits of thier total visits.
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