publication

Dual Eligibles

Care and services for people who have both Medicare and Medicaid

    On January 10, 2023, Governor Gavin Newsom released California’s 2023-24 proposed budget. The proposal includes program changes that impact services for older adults and people with disabilities.

    Enacted on June 30, 2022, California’s 2022-23 budget addresses longstanding system challenges related to health care, long-term services and supports, workforce, and housing for older adults, people with disabilities, and their caregivers. It includes a $17 billion broad-based relief package and continued investment in implementing the Master Plan for Aging. 
    On January 10, 2022, Governor Gavin Newsom released the 2022-23 proposed budget. The proposal includes several program changes that impact services for older adults and people with disabilities.
    Enacted on July 12, 2021, California’s 2021-22 budget addresses longstanding system challenges related to health care, long-term services and supports, workforce, and housing for older adults, people with disabilities, and their caregivers. It reflects the recommendations of the governor’s Master Plan for Aging issued earlier in 2021, and includes $4.6 billion to enhance access to home- and community-based services (HCBS), as outlined in California’s proposed HCBS Spending Plan.
    On May 14, 2021, California Governor Gavin Newsom released the May Revision of the 2021-22 proposed budget. The revision includes a $75.7 billion surplus with investments in economic recovery related to COVID-19 and resources to implement the Master Plan for Aging.
    On January 8, 2021, California Governor Gavin Newsom released the 2021-22 proposed budget. The proposal includes program changes that impact services for older adults and people with disabilities.
    On June 29, 2020, California Governor Gavin Newsom signed California’s 2020-21 budget. The budget addresses the $54.3 billion deficit while maintaining funding for critical programs serving older adults, people with disabilities, and family caregivers.
    On January 10, 2020, California Governor Gavin Newsom released the 2020-21 proposed budget. The proposal includes program changes that specifically impact services for older adults and people with disabilities.

    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.
    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.
    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
    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.
    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.
    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.