Posted February 3, 2015
This January, California's dual eligible demonstration called Cal MediConnect experienced the largest monthly enrollment since operations began. This update provides an overview of enrollment and program changes since August 2014.
Posted November 3, 2014
Individuals eligible for both Medicare and Medicaid are among the highest-need populations in either program. States integrating care for this population must ensure that individuals’ health and social service support needs are addressed promptly. Stratifying Medicare-Medicaid enrollees by their level of need may help states and health plans in better prioritizing and promptly addressing care management to ensure high-quality, timely care.
Posted August 19, 2014
The Coordinated Care Initiative (CCI) changes the way the medical care and long-term services and supports systems serve low-income older adults and people with disabilities. The main components of the CCI include: Cal MediConnect, California’s dual eligible integration demonstration; Mandatory enrollment of individuals eligible for both Medicare and Medi-Cal into managed care; and Integration of Medi-Cal-funded LTSS into managed care (MLTSS).
Posted June 18, 2014
Posted June 6, 2014
Giving low-income older adults in California a voice in their own care is critical to making a seamless transition into Cal MediConnect, a new managed care program for dual-eligibles, according to a policy note by the UCLA Center for Health Policy Research.
Posted April 29, 2014
In 2009, The SCAN Foundation in partnership with the state Department of Health Care Services brought together all sources of payment data for Californians eligible for both Medicare and Medi-Cal. The goals were to understand the needs and service use of this population better to know what works and what doesn’t in care delivery. This new report gives a much clearer understanding of the system inefficiencies and more importantly, missed care delivery opportunities.
Posted April 22, 2014
LTSS includes home and community based services (HCBS) as well as care delivered as a part of an extended stay in a nursing facility (NF). This research examined the patterns of health care related events and expenditures that preceded and followed the initiation of LTSS as well as the pattern of LTSS use following a hospitalization. This research identified 474,706 adult (ages 18 years and older) fee-for-service MME beneficiaries in California who initiated at least one type of LTSS during the two-year period of January 2006 to December 2007.
Posted April 17, 2014
Enacted as part of the 2012-2013 California Budget, the Coordinated Care Initiative (CCI) began operation on April 1, 2014. The CCI establishes changes in the way the medical care and long-term services and supports (LTSS) systems work together to serve low-income older adults and people with disabilities. The main components of the CCI include:
Posted April 15, 2014
State Medicaid programs are moving from fee-for-service to managed care delivery systems for individuals with complex care needs, particularly those who are dually eligible for Medicare and Medicaid or who use long-term services and supports. To provide better integrated and more cost effective care, states are developing managed long-term service and supports programs or capitated financial alignment demonstrations for dually eligible individuals.
Posted February 24, 2014
Behavioral health disorders—which include mental illness and/or substance use disorders—are among the most prevalent and disabling conditions affecting individuals who are eligible for Medicare and Medicaid (also known as “dual eligibles” or Medicare-Medicaid beneficiaries). One in four Medicare-Medicaid beneficiaries aged 65 and older and nearly 40 percent under age 65 have a mental health disorder.