Community Medical Centers and Adventist Health said this week their joint venture health-care network intends to contract with Anthem Inc. to provide managed care for Medi-Cal patients in Fresno, Kings, Madera and Tulare counties.
The new network expects to reach a plan-to-plan contract this summer and be able to begin providing services by Jan. 1.
Working through the new Community/Adventist Health network, services would be provided to Anthem’s managed Medi-Cal members in the four counties. The new relationship could add about 80,000 members to the network, building upon more than 16,000 managed Medi-Cal members it currently serves in Kings County, Community said.
“Anthem’s early interest in our network is significant. It demonstrates the need for a health plan focused on our region’s Medi-Cal patients, and it speaks to the strength of our medical staffs and facilities,” said Aldo De La Torre, Community’s senior vice president of managed care. De La Torre estimates that within two years, the health network could deliver coordinated, clinically integrated care to as many as 200,000 managed Medi-Cal patients.
The arrangement will build on an agreement Adventist already has with Health Net for the administration of benefits for Medi-Cal patients in Kings County. The Hanford-based Adventist has said it has formed an Adventist Health plan to take responsibility from Health Net for 13,000 Medi-Cal members. Medi-Cal is the state-federal insurance for the poor.
Under the Community/Adventist joint venture, which is subject to approval by the California Department of Managed Health Care, the two health systems will remain independent organizations, but the new health plan will be equally financed and jointly owned by the two health care organizations.