What They’re Watching: Chet Uma, Aetna Better Health of California

Chet Uma is the Chief Executive Officer at Aetna Better Health of California. Uma joins us in this edition of “What They’re Watching” to discuss navigating regulations and California’s vision for Medicaid managed care.

 

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“With the increased regulations in California managed care, we have two regulators: DMHC for the Knox-Keene requirements and then of course DHCS for the Medicaid program. [There are] all of these regulations coming in through All Plan Letters (APLs) and it’s a lot to handle and make sure our organization is compliant with all of those.

Like any other health plan, we have only so much time and resources to spend pre-planning. But most of the time it is firefighting, if you may. You know, we just have to balance it out and make sure we have enough resources who are strategic and forward thinking to meet the requirements of DMHC and DHCS.

The state is trying to put everything together under managed care plans for managed care plans to be the one and all, you know, provider whether it comes to physical health, behavioral health, or oral health. At the same time, with the recent carve out of the pharmacy…mixed messages. What is California’s game plan? I think that’s something we need to probably shore up on. Is it going to be carving out of programs in the future? At the same time, we get other programs put in managed care. So, you know, where are we headed as a state when it comes to Medicaid managed care?”