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Office of the Patient Advocate - State of California


Much of this information is right at your fingertips in the online Health Care Quality Report Cards produced by the Office of the Patient Advocate.
When choosing a health plan
Be sure to factor in quality in order to get the best value. You can use the Health Care Quality Report Cards to compare ratings for California’s largest HMO and PPO plans.
When choosing a provider or medical group
Pay attention to both quality and cost to get the best value. If your doctor is part of a medical group, you will typically get referrals to see specialists and other providers within this medical group. Select your county to compare quality and cost ratings for medical groups in your area.
To use the cost ratings when choosing a medical group
Generally, you want to try to get the best quality care at the lowest cost. The cost ratings are based on the average payment made by the patient and the patient’s health plan for care. Independent research shows that medical groups that receive higher payments do not necessarily provide higher quality care.
Choosing a medical group that receives higher payments may mean that you will pay more to get medical care.

When prices are higher, you may pay more for care before meeting your deductible or for your co-insurance share of a medical bill.
The actual amount that you pay out-of-pocket depends on the details of your insurance policy or health plan.

If a health plan or medical group does not score well on quality
You can still get quality care from a low-scoring health plan or medical group. You may need to work more closely with your doctor and health plan to make sure you are getting the right care.

A good starting point is to look at what care is recommended under the different health topics within the Report Cards.
Talk to your doctor about what care is right for you.
Contact your health plan’s member services if you are having problems using your plan.

To learn more about recommended care
You can click the “read more” link within the various health topics on the online Report Cards to find out more about what care is recommended. Talk with your doctor to decide what care is right for you.

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Every home in the U.S. is eligible to order free at-home COVID-⁠19 tests. The tests are completely free. Orders will usually ship in 7-12 days. https://covidtests.gov.If you already ordered 4 free at-home COVID-19 tests from https://www.covidtests.gov/, now you can get 4 more free at-home tests shipped to your home. Visit https://www.covidtests.gov/ again to place your second order. As before, just enter your name and mailing address (you can also give your email address if you want status updates on your order).If you haven't yet ordered any at-home tests, you can get a total of 8 tests shipped to your home. You'll just have to place 2 separate orders — each order equals 4 tests.If you need a COVID-⁠19 test now, please see https://coronavirus.cchealth.org/get-tested for local testing resources.Contra Costa Health Call Center: (844) 729-8410 Open Daily from 8:00 AM - 5:00 PM.Get Tested: (844) 421-0804 Open Daily from 8:00 AM  - 3:30 PM.Vaccine Appointment Helpline: 1-833-829-2926Open Daily from 8:00 AM  - 8:00 PM.Please only use the phone line if you do not have access to the internet or are having difficulty with the online form.

 
 
 

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Did You Know Your Health Plan Includes These Perks? - CalPERS PERSpective
Self-Care Apps — Download Calm, myStrength, and Headspace Care (formerly Ginger) at no cost to support your mental health and emotional well-being. While each app has a different focus and format, they’re designed to help you improve sleep, develop self-care skills, and guide you through meditations provided by world-renowned teachers and thought leaders.
Sharp Health Plan
Wellness Incentive — You can earn a $150 reward by participating in a six-week program that includes completion of online learning activities or telephonic personal health coaching program that focuses on a health issue of your choice.
Personal Health Coaching — A personal health coach needn’t be a luxury. Take part in a customized six-week program, conducted privately over the phone, that can include elements such as healthy weight, smoking cessation, healthy eating, physical exercise, and stress management.
UnitedHealthcare
Wellness Incentive Program — Make more informed health and lifestyle decisions, and earn rewards like gift cards, health savings account deposits or reimbursements, and more.
OnePass Select — Get a subscription-based fitness and wellness program to support a healthier lifestyle. Based on your subscription choice, you’ll have access to gyms, studios, online workouts, and grocery delivery services with one monthly membership. Access the program through your UnitedHealthcare member portal.
Western Health Advantage
Gym and Fitness Center Discounts — You can access a range of fitness centers for a minimal monthly fee through Western Health Advantage’s partnership with Active&Fit Direct.
Healthy Recipes — Eating healthy, coupled with physical activity, leads to lasting weight loss. Other benefits of eating whole, homemade foods include decreased risk for and treatment of infections and disease, improved emotional well-being, and lengthened longevity.

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Page Content Main​​​​​​​Introduction​The Department of Human Resources (CalHR) is committed to protecting your privacy rights as individuals. Our commitment to protecting your personal information underscores our respect for your privacy rights and confidentiality. CalHR's policy limits the collection, utilization, and disclosure of personal information maintained by CalHR, as well as implements safeguards to ensure its protection and confidentiality, all while striving to ensure transparency and trust in our practices. CalHR's information management and privacy practices are governed by State and Federal laws such as:California Constitution, Article 1, Section 1Government Code Section 11015.5Health Insurance Portability and Accountability Act (HIPAA) of 1996 – Privacy RuleInformation Practices Act (Civil Code Section 1798 et seq.)Public Records Act (Government Code Section 6250 et seq.)State Administrative Manual (SAM) Section Privacy - 5310 et seq.Statewide Information Management Manual (SIMM) 5310-A and 5310-BNational Institute of Standards and Technology (NIST) Special Publication 800-53 Information We CollectCalHR only obtains personal information through lawful means. The personal information collected directly from you is voluntary and is only used to accomplish the specified business purpose the data is meant to be used for. This data may include personal and health/mental information CalHR needs to conduct our official responsibilities in human resources including but not limited to examinations, certification, payroll, benefits, and statewide training. Failure to supply the information results in CalHR's inability to perform its business function.
Office of the Patient Advocate - State of California


Information on clinical trials.
Centers for Disease Control and Prevention  www.cdc.gov
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Information on clinical trials.
County Medical Services Program (CMSP) www.cmspcounties.org
Health care for low-income adults in 34 California counties.
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Drug Digest  www.drugdigest.org
Check for drug interactions.
Families USA  www.familiesusa.org
National organization that advocates for health care consumers. Information about health policy issues.
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Find a health center that provides no-cost/low-cost care to the uninsured. Payment is based on your income and what you can afford.
Health Consumer Alliance www.healthconsumer.org
Information in many languages on low-cost health care (Click on publications).
The 2024-25 Budget: California Student Aid Commission
Background
Cal Grant Program Is the State’s Largest Financial Aid Program. The Cal Grant program is intended to help students with financial need cover college costs. The program offers multiple types of Cal Grant awards. As Figure 3 shows, the amount of aid students receive depends on their award type and the segment of higher education they attend. Cal Grant A awards cover full systemwide tuition and fees at public universities and a fixed amount of tuition at private universities. Cal Grant B awards provide the same amount of tuition coverage as Cal Grant A awards in most cases, while also providing an “access award” for nontuition expenses such as food and housing. Cal Grant C awards, which are only available to students enrolled in career technical education programs, provide lower amounts of tuition and nontuition coverage. Across all award types, larger amounts of nontuition coverage are available to students with dependent children as well as current and former foster youth. 

Figure 3
Cal Grant Amounts Vary by Award Type, Sector, and Student Characteristics
Maximum Annual Award Amount, 2023‑24

Amount

Tuition Coverage

Cal Grant A and Ba

UC

$13,752b

Nonprofit institutions

9,358

WASC‑accredited for‑profit institutions

8,056

CSU

5,742

Other for‑profit institutions

4,000

Cal Grant C

Private institutions

$2,462

Nontuition Coverage

Cal Grant A

Students with dependent childrenc

$6,000

Foster youthc

6,000

Cal Grant B

Students with dependent childrenc

$6,000

Foster youthc

6,000

All other students

1,648

Cal Grant C

Students with dependent childrenc

$4,000

Foster youthc

4,000

Other CCC students

1,094

Other private‑institution students

547

aCal Grant B recipients generally do not receive tuition coverage in their first year. 
bReflects award amount for new UC students.
Health Vesting: What Is It, and How Much Will Your Employer Contribute in Retirement? - CalPERS PERSpective
To learn the vesting schedule that applies to you, based on your bargaining unit and hire date, view pages 19 and 20 of the CalPERS Health Program Guide (PDF).
State and CSU employees can also log in to myCalPERS and visit Health Vesting under the Health tab. If you’re within five years of your minimum retirement age you can use the Health Into Retirement Calculator in your myCalPERS account. This tool allows you to review the state’s share of premium based on the current year plan premiums.
While the premiums change each year based on the approved rates, the state’s contribution changes annually too, providing a good estimate to plan for your health in retirement.
Employees of public agencies and schools should contact their employer to determine if health vesting applies to them and to find out how many years of service credit is needed to receive the employer’s contribution toward their premium.

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Office of the Patient Advocate - State of California


Among the findings are a high need for certain types of health care, such as mental health services, as well as a growing reliance on high-deductible health plans, especially among the low-income and self-employed.
2006 survey: What Consumers Want to Know About Their HMOs
OPA recently commissioned a random sample survey of 1,224 adult Californians enrolled in HMOs. Goals of the survey were to:

 Determine the kinds of information HMO enrollees would like to know about their health plan and how it works.
Identify the sources of information that consumers trust and the sources of information they find most useful. Specifically, the survey sought to understand how consumer information needs vary by source of coverage (employer, Medicare, or Medi-Cal), demographics, and geography.
Document the changes in consumer experiences since 1997, when a similar survey was conducted.​

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2013 Policy Brief – Limited English Proficient HMO Enrollees Remain Vulnerable to Communication Barriers Despite Language Assistance Regulations
More than 1.3 million California HMO enrollees ages 18 to 64 do not speak English well enough to communicate with medical providers. This policy brief from the UCLA Center for Health Policy Research found that health plan enrollees with limited English skills reported the poorest health and were more likely to have difficulty understanding their doctors, placing this already vulnerable population at even greater risk.

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The 2024-25 Budget: Medi-Cal Analysis
While we now have a clearer picture of caseload through 2024‑25 than our office or the administration had last fall, waiting to approve any change to the Medi‑Cal budget until after release of the May Revision would be prudent, as the picture will become even clearer by then. We will make our final assessment and recommendations based on the administration’s revised estimates at that time. 
Administration’s Caseload Estimates Possibly an Indication of Positive Impact of Flexibilities… As described earlier, our November Fiscal Outlook projections of Medi‑Cal caseload were based upon our office’s projections of economic and demographic factors. In general, we estimated what Medi‑Cal caseload would have been absent the continuous coverage requirement and brought caseload down to that level over the unwinding period. We did not factor in early months of preliminary data on redeterminations, nor did we make explicit assumptions about the extent to which the state’s several federally approved flexibilities would impact caseload. The Governor’s budget projects that caseload will bottom out around 1.6 million enrollees higher than we projected in November 2023. This appears to be an indication that the state’s efforts to maximize the continuity of coverage for Medi‑Cal enrollees are working. Another indication of the success of these efforts is the state’s performance relative to other states. 
...But What Happens to Enrollees If Flexibilities Expire? In December 2023, CMS announced that it will extend flexibilities past the end of continuous coverage unwinding through at least the end of 2024. DHCS has communicated its intent to continue some of the eligibility flexibilities (to the extent permitted by the federal government) while letting others expire. Depending upon future federal and state actions, the state’s recent success in minimizing the impact of continuous coverage unwinding on enrollees may only be temporary. The extent to which the state’s efforts continue to be successful or, alternatively, caseload begins to return to more normal levels over the next few years, will be an important issue to watch. 
MCO Tax Budget Solution
In this section, we analyze the Governor’s proposed MCO tax budget solution.
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