Daniel Zingale wants to take managed care back to its roots. As director of the newly created state Department of Managed Care, he is charged with overseeing regulation of the California health care industry and enforcing health care reforms passed last year by the state Legislature. The creation of his department was perhaps the most ambitious HMO reform in the nation and is being closely watched by other states.
Since taking office July 1, Zingale has created a hotline (1-888-HMO-2219) and Web site (www.HMOHelp.ca.gov), aimed at helping consumers solve problems and disputes with HMOs. It is the first step in fixing the health care system in California.
But his main mission, he said, is to put preventative care back into the managed care equation. It is, he said, the only way to save the managed care system and keep it profitable.
Zingale lobbied Gov. Gray Davis for his job. He has spent the last 10 years as a patient advocate in Washington, D.C., first for the American Psychological Association, where he helped create a model for mental coverage under HMOs, and later for AIDS Action. In his latter position, he gained recognition for shifting the group's focus from the treatment of AIDS to the prevention of the disease.
Now he hopes to do the same for California's entire health care industry.
Question: What's your first priority for this new department?
Answer: The big answer to that is, to improve the quality of managed health care conditions in California. I think the first step toward doing that is to build an effective and responsive HMO health center, so consumers can call the Department of Managed Health Care when they're having a problem they can't resolve and know that they'll get the kind of assistance they'll need. I'm very pleased with the progress we're making with that. We've done a great deal of training of the staff in terms of effective communications with the public and making sure they're equipped with the knowledge they need to empower patients in advocating for themselves.
Q: How has the public response been to the hotline and Web page so far?
A: I believe it's approaching half a million visits to the new Web site, which is terrific. And a large number of people are taking advantage of the assistance of the call center. What I'm most pleased with is, the obstacles to patient care have been resolved immediately. Take disagreements between patient and HMO about coverage; in the past, that dispute would sometimes be dragged out for weeks, months and into the realm of extended litigation. Oftentimes it hasn't been resolved until the harm to the patient is already done and you're trying to set a price on the harm to the patient. What I believe is happening now is, many more of those disputes are being resolved proactively on the front end, and the patient is being given care where appropriate before we get to that point.
For reprint and licensing requests for this article, CLICK HERE.