publication

Dual Eligibles

Care and services for people who have both Medicare and Medicaid


Californians with Medicare and Medi-Cal have many choices to get the health coverage they need, but choices vary by county. This brief outlines available choices across the state and describes the My Care, My Choice web resource.
On June 27, 2019, California Governor Gavin Newsom signed California’s 2019-20 budget. The budget reflects new program investments for older adults and people with disabilities, including staff resources for the state’s Master Plan for Aging.
On May 9, 2019, California Governor Gavin Newsom released the May Revision of the 2019-20 budget. The revision includes modest program changes that impact services for older adults and people with disabilities, including staff resources for the state’s Master Plan for Aging.
On January 10, 2019, Governor Gavin Newsom released the 2019-20 proposed budget. Learn which modest program changes would impact services for older adults and people with disabilities.
Drawing from four years of Cal MediConnect evaluation results, this brief highlights recommendations for policymakers and health plans to consider in improving integrated systems of care for people with Medicare and Medicaid.
In this Perspectives, Dr. Chernof discusses The SCAN Foundation’s web-based tool to empower California’s dual eligibles with a better understanding of their care choices, based on both their location and the medical and supportive services
On June 27, 2018, Governor Brown signed California’s 2018-2019 budget. In this fact sheet, read a summary of budget items impacting older adults and people with disabilities.
On May 11, 2018, California Governor Edmund G. Brown, Jr. released the May Revision of the 2018-2019 budget. While it includes a significant increase in revenues and modest program investments for older adults and people with disabilities, the state still has no overarching master strategy to meet the needs of an aging California. Read more in this fact sheet.
In this Perspectives, Dr. Chernof reviews what's missing from Governor Brown's proposed 2018-2019 budget. It outlined modest adjustments to programs impacting older adults and people with disabilities and focuses on building the financial stability of the state, paying off debt, and strengthening elements of our infrastructure. It fails, however, to outline solutions to the challenges facing California’s older adults and people with disabilities.
On January 10, 2018, California Governor Brown released the proposed 2018-2019 budget. In this fact sheet, learn what modest program changes impacting older adults and people with disabilities were included, and where the budget falls short.
Read the Foundation’s top 10 recommendations for improving integrated systems of care for people with Medicare and Medicaid, also known as dually eligible individuals.
Since inception six years ago, enrollment for The SCAN Foundation’s California Summit on Long-Term Services and Supports (LTSS) has doubled. The LTSS Summit provides a rare opportunity for service providers, aging and disability advocates, health
As California’s Medicare-Medicaid demonstration becomes more established, a clearer picture is emerging. Over the last 18 months, Field Research Corporation and the University of California have completed numerous evaluation activities to better understand the experiences of dual eligible individuals (both those who enrolled in Cal MediConnect and those who opted out), health plans, health systems, and community-based providers. In this Perspectives, Dr. Chernof examines this rich body of work, identifying successes and what needs to improve as the demonstration moves forward.
Coordinated care makes a difference.  It prevents avoidable hospital re-admissions, transitions people out of institutional settings, and helps people thrive in their communities.  Read Karen's case study.
Coordinated care makes a difference.  It prevents avoidable hospital re-admissions, transitions people out of institutional settings, and helps people thrive in their communities.  Read Zena's case study.
Coordinated Care Makes a Difference.  It prevents avoidable hospital re-admissions, transitions people out of institutional settings and helps people thrive in their communities. Read Gabriela's case study.
Coordinated Care Makes a Difference.  It prevents avoidable hospital re-admissions, transitions people out of institutional settings and helps people thrive in their communities. Read Josephine's case study.
Coordinated Care Makes a Difference.  It prevents avoidable hospital re-admissions, transitions people out of institutional settings and helps people thrive in their communities.  Read Chito's case study.
In this Perspectives, Dr. Chernof explains what recent polling results and coordinated care stories tell us about the experiences of Medicare-Medicaid individuals, and identifies opportunities to further strengthen and expand support.
Our annual summits create space for thought-leaders to learn and dialogue with each other about critical windows of opportunity, and how best to transform California's long-term services and supports ystem. Read Dr. Chernof's Perspectives on some key areas for system transformation that were discussed at the 2015 LTSS Summit.
California is among a dozen states participating in the national demonstration to improve care for people with serious chronic illnesses and functional limitations who qualify for both Medicaid and Medicare. We commissioned the Field Research Corporation to poll the state's dual eligibles, including people enrolled and those opting out in five demonstration counties as well as people in non-demonstration counties. Find out more in this week's Perspectives.
Stratifying Medicare-Medicaid enrollees by their level of need may help states and health plans prioritize and promptly address the care management needs of these individuals in order to ensure high-quality, timely care. This brief from the Center for Health Care Strategies describes how three states - California, Ohio, and Virginia - are accomplishing this work.
Sadly for most vulnerable older Californians, their first interaction with long-term services and supports (LTSS) begins in the emergency room. A recent report from California’s Medicaid Research Institute (CAMRI) shows that this perspective is particularly true for individuals covered by Medicare and Medi-Cal. Most people who used Medi-Cal-funded LTSS started these services after an emergency room visit, hospital admission, or rehabilitation stay. Older adults entering these institutions may experience additional health complications, be discharged with less function than when they entered, and find their support system at home less prepared to meet their needs.
The findings contained in this report demonstrate the inter-relationship between acute, postacute, and long-term services and support (LTSS) services for Medicare and Medicaid Enrollees (MMEs).
Following on previous reports describing the population who uses Medi-Cal-funded long-term services and supports, the California Medicaid Research Institute has produced a report that describes key characteristics of the population using LTSS across each of the state’s 58 counties. This report describes spending and service use patterns across the 58 counties.
This report describes nursing home stays of two of California's most vulnerable populations: those who are dually eligible for Medicare and Medi-Cal and Medi-Cal only beneficiaries. Findings suggest the need for improved coordination between health care and long-term services and supports systems in order to more efficiently and effectively provide services to meet people's needs.
On March 27, 2013, the State of California and the Centers for Medicare and Medicaid Services (CMS) formalized a Memorandum of Understanding (MOU) to establish a Federal-State partnership to implement the Dual Eligibles Integration Demonstration, also referred to as Cal MediConnect. This Fact Sheet provides background information about Cal MediConnect and summarizes the key points of the MOU.
The California Medicaid Research Institute (CAMRI) developed an integrated and longitudinal database containing Medi-Cal and Medicare claims and assessment data of LTSS recipients in California in 2008. CAMRI's integrated database provides a unique opportunity to look at characteristics and program spending across the entire care continuum for beneficiaries with LTSS needs within Medi-Cal and for dual eligibles across Medicare and Medi-Cal. This report focuses on LTSS use and spending in the eight duals demonstration counties.
This is the third report coming from the California Medicaid Research Institute (CAMRI) project entitled: Comprehensive Analysis of Home- and Community-Based Services in California. The report describes Medicare and Medi-Cal spending for those beneficiaries using long-term services and supports funded by Medi-Cal.
This fact sheet provides the background and context for California’s Coordinated Care Initiative (CCI), established as part of the enacted 2012-2013 budget. It outlines the changes to the delivery of medical care and longterm services and supports (LTSS) for individuals eligible for Medicare and Medi-Cal as well as Medi-Cal-only seniors and people with disabilities initiated by the CCI.
The California Medicaid Research Institute (CAMRI) compiled a report that identifies Californians who receive home-and community-based support and what services they receive. The brief brings together available information spread across multiple state and federal data systems.
In this brief, the California Medicaid Research Institute documents its process to acquire and link all the data sources necessary to evaluate long-term care services utilization, costs, and outcomes in California. This provides useful information about how data currently flows in the state and how system transformation can be supported.