We talked about how the county’s $1 billion health insurance program for the needy was digging into its piggy bank to pay medical bills while the state’s finances were paralyzed.

(Note to lawmakers: Poor folks don’t stop getting sick just because the state has no budget.)

CalOptima has furnished the numbers, and they show that cash and reserves were:

• $226.6 million on July 31,
• and were sucked down to $121.8 million as of Sept. 18.

There’s another $24 million in checks that haven’t yet cleared. So CalOptima’s piggy bank has been been drained by more than half.

Yes, that money will be replaced by the state. At some point. But with $80 million worth of medical bills piling up every month - that’s some $2.7 million a day - you can appreciate that the situation was acute.

Doctors were glad that CalOptima kept paying, but are unhappy with a cut imposed on reimbursements. Especially since documents that show that, while cutting pay to doctors, the agency recently gave one top administrator a 10 percent raise, and other employees got $600,000 in pay raises.

(Note that CalOptima’s CEO didn’t take any raise at all, and that the agency shaved $1.4 million from what it would have paid for administrative costs if the state budget wasn’t in such trouble.)

 FUN FACTS

• In its 2007 report to the community, CalOptima boasted that it spends nearly 96 percent of its revenue on medical care, and only 4.1 percent of revenue on administrative costs. That was the lowest among similar health plans in the state, and the second-lowest among all public health plans in California. 
• CalOptima administers health insurance programs for more than 330,000 people in it’s Medi-Cal, Healthy Families, Healthy Kids and Medicare programs.
• People who qualify are low-income families, children, seniors and persons with disabilities.
• CalOptima provides its members with access to a network of more than 5,000 primary care doctors
  and specialists, as well as nearly 30 hospitals.

More Watchdog:

• CalOptima staff gets raises while cutting fees to doctors
• OC doctors, paid from ‘piggy bank,’ dislike fee cut
• Hoag, CHOC hospital execs earn more than $1 million each
• Anaheim Hospital: “Reasons for Sale”
• Anaheim Hospital Foundation founders; what of its $1.7 million?
• Anaheim Hospital Foundation stumbles
• ‘Nightmare story:’ retirement fund loses $300 million

Posted in: Money • Nonprofits • Public health |

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