CalOPTIMA’s Healthy Concept

* Re “CalOPTIMA’s Success,” Nov. 15 editorial:

As a “traditional” provider who was providing care for those covered by Medi-Cal before the implementation of CalOPTIMA, I viewed the implementation of the county-run plan with much trepidation, since the population served by this plan comprised the bulk of my practice.

In fact, I immediately arranged a business loan because I knew the cash flow of my practice would be at least temporarily compromised, even in the event of its success.

CalOPTIMA has dramatically increased the access of this population to health care services, especially specialty and diagnostic services.

Before CalOPTIMA, I dreaded having to refer patients to specialists or the hospital, feeling that I had to apologize for the second-class service or pay scale that Medi-Cal had to offer. Now, in the managed-care structure that the majority of CalOPTIMA patients are serviced with, specialty and hospital referrals are part of a predetermined, contractually agreed-upon process.

My practice has continued to grow, primarily serving the same population that I was seeing before the CalOPTIMA transition.

My patients have been able to retain me as their primary care provider because CalOPTIMA agreed to the use of physician-hospital consortiums that were formed by many of the traditional providers and local hospitals.

The administration at CalOPTlMA has shown a commitment to quality of care and to the idea that access to primary care, with great emphasis on preventive services, will continue to reduce health costs.

CalOPTIMA is succeeding largely because the traditional primary care providers for this population are now provided with adequate health resource tools to enable us to provide and direct the care for our patients.

DAVID J. KEULEN, MD

Stanton