California Medicaid Research Institute: Service Use and Expenditures Before and After Entry into California’s LTSS Programs
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).Date Updated: 04/22/2014
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.
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.
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.
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.