Being a public HMO, have their enrollees had difficulties related to the number of providers who accept/don't accept Medi-Cal? I don't know what the stats are for physicians accepting Medi-Cal, but for dentists it's something like only 40 percent of them are accepting Denti-Cal patients. On a wider scale, do managed care organizations, either public or private, have any avenues of action when it comes to convincing providers to accept patients on the managed care plan in question?

It seems that L.A. Care utilizes incentive programs on multiple levels. In terms of doctor incentives, have you seen improvements in the patient pool that they serve - are they healthier as a whole? Have you found that "monetary" incentives are the only way to motivate both doctors and patients toward health?

Also, how do community providers become a "safety net provider?"

My questions for L.A. care would be:

What kind of marketing do they do outside of their website to reach Los Angeles' communities?

How do they address the barriers in health care such as language differences, immigrants, lack of transportation?

Which one of the 4 programs do most of their clients generally qualify for?

Going along with what a couple people have already posted..

I would like to know what guidelines LA Care puts on its physicians in terms of what procedures they should be doing. Are physicians directed to try more cost-effective measures first to try to solve a problem before moving to more expensive procedures, even if the more expensive procedures have a statistically-better chance of solving the problem in the first go-round? Are there any financial incentives for the physicians to use cost-effective methods/procedures? Also, since physicians are most likely salaried, what are their (financial) incentives to providing better care?

I would ask what kind of a services offered need an authorization to receive? Also, once a patient receives authorization for treatment, how long must the patient wait from the time they receive authorization to the time they receive care? If a patient is hospitalized in a facility not within LA Care's network, once the patient is stabilized, does LA Care cover the cost to transfer the patient to a LA Care facility, does their insurance cover it, or does the patient have to pay that out of pocket?

I would ask, since this HMO is a public HMO, do they drop any of their poor consumers? Also, I would ask how are their health indicators compared to other HMOs. I would think that LA care has patients who advocate less for themselves so their costs would be decreased and maybe their health indicators.

I would ask LA Care how do people qualify for this plan? Does it provide for the couples that are over 50 and does not have a job yet lives with family? Does each applicant have their own worker? What is the interview or paper process? How long will the person know that they are covered by LA Care?