Truong: California must improve health plan choices

I am honored to be joining San José Spotlight’s team as a new business opinion columnist. As a lifelong resident of San Jose and having been involved in the local business community for the past eight years, I hope to share interesting perspectives on business issues through this publication.

In 2019, I shared my personal experiences with San José Spotlight about my family’s small business and how they often had to choose between paying the mortgage or for health care services. As minorities and political refugees, my parents created their own opportunities by starting a retail small business. This often meant working at least 12 hours a day and taking long drives to Southern California to purchase wholesale products for the business.

Sadly, my story is not unique, and I believe that many minorities had to sacrifice their health for survival in America. If it were not for California’s Medi-Cal system, my father would not have lived for as long as he did after we discovered that he had stage four kidney cancer. That is why I am passionately and closely following the future of Medi-Cal services in the state.

Currently, depending on which county you live in, Medi-Cal beneficiaries can choose between a county-administered plan or a commercial plan provider. More health plan choices provide more quality care options for Californians of the highest needs.

On Feb. 9, the California Department of Health Care Services (DHCS) unveiled a public bid process for commercial health plans to provide health care services under the Medi-Cal Managed Care Plans procurement. This is particularly notable as this was California’s first statewide procurement. Some of DHCS’ stated procurement goals were:

1. Increasing transparency
2. Accountability
3. Health equity
4. Quality
5. Local engagement

Despite these stated goals of improving quality of care and outcomes for Medi-Cal beneficiaries, DHCS announced its intent to award Medi-Cal contracts to the same for-profit companies that are currently under contract across the state. What is worse is that the procurement process favored for-profit companies with lower quality scores and rewarded the same plans with subpar performance.

The hope was that the bid would factor in the communities being served by the Medi-Cal program, but the decision placed little or no value on having a strong, local presence or ties with local community organizations. Based on the documents released thus far, it is not clear the state department corroborated the track record of the applicants, verified their claims and commitments or checked in with the community leaders who are deeply invested in the program. In a progressive state that values community, shockingly the nonprofit applicants were shut out completely, despite their deep roots in the state and in our neighborhoods.

I’ve seen firsthand the investments and the type of community engagement that will benefit Santa Clara County and others across the state.  Not only should our Medi-Cal plans deliver high quality care, but they should also address the social determinants of health by building permanent homes for the unhoused, such as through Project Homekey, and supporting hyperlocal nonprofits.

I hope that California is not limiting fair competition in favor of administrative ease to manage a handful of commercial health plans. How would this decision have helped people like my dad? It may be too late to get better quality care for my dad, but it’s not too late to demand better health care options for future generations who deserve better.

Gov. Gavin Newsom should do the right thing and call for a re-do of the Medi-Cal contract process to allow more local, nonprofit health plans to participate.

San José Spotlight columnist Eddie Truong is a principal at DT Strategies, a San Jose-based business consulting firm, and co-founder of the Silicon Valley Restaurant Association. His columns appear every second Wednesday of the month.