Clinicas to Operate as a Professional Risk Bearing Organization
OXNARD — Gold Coast Health Plan (GCHP) and Clinicas del Camino Real Inc. on Monday announced the signing of a specialty physician contract that designates Clinicas as a Professional Risk Bearing Organization.
“We are proud to announce that Gold Coast is strengthening our relationship with Clinicas and we are confident that this arrangement will improve the care of our most vulnerable members,” Michael P. Engelhard, chief executive officer (CEO), GCHP, stated in the media release
“Clinicas brings a knowledge, vision and a wealth of experience in treating our Medi-Cal Members and that will only be enhanced by this agreement,” he said.
Under the new arrangement, GCHP will delegate authority of approximately 14 thousand Medi-Cal members to Clincas who in-turn will arrange for their care by specialty physicians in their network. Clinicas currently provides primary care services to these members. Compensation for those services will be on a capitated risk or fixed per member per month payment and Clinicas will be responsible for the processing and payment of claims made by specialty providers. GCHP will continue to maintain oversight authority of all Clinicas operations as they relate to their Medi-Cal members.
“Clinicas intends to leverage its 41 years of health delivery experience and clinical expertise to ensure Medi-Cal members receive the best care possible,”Roberto S. Juarez, chief executive officer (CEO), Clinicas del Camino Real Inc., stated in the release. “Today’s agreement with Gold Coast Health Plan underscores our unbroken promise of providing affordable health care for the residents of Ventura County.”
Clinicas notified their provider network regarding the agreement and reviewed all aspects of the contract prior to the announcement to ensure for a smooth transition. The agreement emphasizes the commitment of GCHP and Clinicas to work together in ways that enable them to take broader responsibility for the members they serve.
For more information regarding this issue please contact GCHP at 888-301-1228 or Clinicas at 805-647-6353 or go to www.clinicas.org
About Gold Coast Health Plan:
Gold Coast Health Plan is an independent public entity created by County Ordinance and authorized through Federal Legislation; however, Gold Coast Health Plan is not a county agency. The Ventura County Board of Supervisors approved implementation of a County Organized Health System (COHS) model, transitioning from fee-for-service Medi-Cal to managed care, on June 2, 2009. The purpose of Gold Coast Health Plan is to serve Medi-Cal beneficiaries, enhance the quality of healthcare, provide greater access, improve service and provide choice. The plan provides health benefits to more than 100,000 beneficiaries in Ventura County, California. To learn more about Gold Coast Health Plan, visit us at: www.goldcoasthealthplan.org or call us at 888-301-1228.
About Clinicas del Camino Real Inc.:
Clinicas del Camino Real Inc. is a private non-profit 501(c)3, that has been providing quality primary heath care to the residents of Ventura County, California for more than 40 years. Started as a “Free Clinic” providing medical care to migrant farm workers in Santa Paula, California in 1971, Clinicas operates thirteen Joint Commission accredited health centers within Ventura County in Santa Paula, Fillmore, Ojai, Ventura, Newbury Park, Oxnard, Simi Valley and Moorpark. Additionally in 2011, Clinicas was the third organization in California to receive the Joint Commission’s Primary Care Medical Home certification. Clinicas provides a comprehensive array of health care services, including Family Practice, Pediatrics, OB/GYN, Internal Medicine, Cardiology, Chiropractic, Podiatry, Family Dentistry, Optometry, Pain Management, Psychiatry and Behavioral Health Counseling. Direct support services include on-site basic laboratory and X-Ray services. Clinicas also provides on-site psychological evaluation and counseling at several local schools, from elementary to high school, and similar psychological counseling at area adolescent group homes. While Clinicas primary patient population continues to be migrant and seasonal farm workers and their families, CDCR has grown to include all persons within Ventura County who lack access to comprehensive affordable health care services. To learn more about Clinicas, visit us at: www.clinicas.org or call us at 805-647-6353.