Perspectives: Good Start, Now Get to Goal – Lessons Learned from California’s Duals Demonstration
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.Date Updated: 08/15/2016
As California’s Medicare-Medicaid demonstration becomes more established, a clearer picture is emerging about its early positive impact on beneficiary lives as well as areas where more work is needed. Over the last 18 months, Field Research Corporation polled over 5,000 respondents to explore the experiences of dual eligible individuals who chose to participate in the demonstration compared to those who chose to keep their Medicare the same. Complementing this critical polling, researchers at UC San Francisco’s Community Living Policy Center and UC Berkeley’s Health Research for Action Center released three additional bodies of work. First, they completed in-depth interviews with providers from health plans, health systems, and community-based providers. They convened over a dozen focus groups, including hard-to-reach participants. Finally, they completed the first round of an extensive survey of more than 2,100 dual eligibles in California. Taken together, this rich body of work presents both beneficiary and provider perspectives…
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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.