Consortium Is on the Verge of Something Big

This health plan boasts no flashy, feel-good billboards, and it’s a pretty safe bet you’ve never heard of it. It hasn’t even enrolled its first member.

But L.A. Care Health Plan is poised to become one of California’s 10 largest HMOs over the next year or so.

L.A. Care, a public-private consortium of private HMOs and other health-care organizations, has a big state contract to provide managed-care programs for Medi-Cal recipients in Los Angeles County. The contract is expected to steer roughly 650,000 of the county’s poor into L.A. Care, part of Gov. Pete Wilson’s statewide plan to force millions of Medi-Cal recipients into private HMOs over the next few years.

So far, L.A. Care has had a bit of a bumpy start. Originally scheduled to start business last June, it has had to postpone its debut several times due to state regulatory delays and other issues.

*

The delays became so worrisome last year that L.A. Care had to obtain $5 million in temporary financing from Kaiser Foundation Health Plan--one of its member HMOs--to help meet expenses. Even so, L.A. Care representatives say they have been unable to kick off public relations and community education campaigns as quickly as hoped.

The most immediate concern for L.A. Care is to win state approval for an HMO license. Chief Executive Anthony Rodgers said he expects approval before April 1. That’s the state’s latest start date for beginning the mandatory enrollment of Medi-Cal beneficiaries in Los Angeles County.

Rodgers said L.A. Care is prepared for the rapid growth to come. The last nine months have been spent putting together the infrastructure--from customer service operations to computer systems--necessary to run a large HMO, he said.

“We feel we’ve built the systems that are necessary and that people have told us will be needed to have a successful program,” Rodgers said. “We are confident that we are prepared to go live.

“Everybody’s biting at the bit to get started,” he said.

When Members Quit

One yardstick for measuring how happy members are with their health plans is looking at how frequently they quit them and why. A recent study by a Los Angeles-based consumer group--based on state health agency records--found wide disparities in “disenrollment” rates among HMOs that serve Medi-Cal beneficiaries in California.

While some HMO members may choose to quit their health plans for practical reasons--for instance, a favorite doctor is no longer in the plan--disenrollment rates can also indicate problems with quality of care or access to medical services, said Peter Lee, a health-care researcher at the Center for Health Care Rights and co-author of the study.

Among the findings: Members of Universal Care, a Signal Hill-based HMO, had the highest percentage of members who cited “quality of care” problems as the reason for quitting the plan. Members of Universal Care and Los Angeles-based Maxicare Health Plans were more than four times as likely as members of other Medi-Cal HMOs to disenroll due to marketing problems.

“There are a number of plans that appear to have significant indicators that they may be providing worse quality of care than other plans,” said Lee. “That’s important as a yellow flag for state health regulators to do further investigation.”

Times staff writer David Olmos can be reached via e-mail at david.olmos@latimes.com or by fax at (213) 237-7837.