Dual Eligibles

Posted June 24, 2015
This brief summarizes California’s implementation of key models from the Patient Protection and Affordable Care Act (ACA) to improve care for older adults and people with disabilities, noting current accomplishments and recommendations for further system transformation.
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 January 7, 2015
A brief from the Center for Heath Care Services explores considerations in aligning Medicare and Medicaid appeals processes and highlights key lessons from two states serving Medicare-Medicaid enrollees.
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 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.