Beneficiaries Respond To California's Program To Integrate Medicare, Medicaid, And Long-Term Services

Health Aff (Millwood). 2018 Sep;37(9):1432-1441. doi: 10.1377/hlthaff.2018.0452.

Abstract

In 2014 California implemented a demonstration project called Cal MediConnect, which used managed care organizations to integrate Medicare and Medicaid, including long-term services and supports for beneficiaries dually eligible for Medicare and Medicaid. Postenrollment telephone surveys assessed how enrollees adjusted to Cal MediConnect over time. Results showed increased satisfaction with benefits, improved ratings of quality of care, fewer acute care visits, and increased personal care assistance hours over time. Enrollees also had somewhat better prescription medication access and lower unmet needs for personal care, compared to the comparison group. The lack of improvement in care coordination raises concerns about the implementation of the care coordination benefit, a key feature of the program. The Bipartisan Budget Act of 2018 contains provisions that permanently certify the use of managed care (such as Dual Eligible Special Needs Plans) to integrate Medicare and Medicaid, which makes the lessons learned from California's duals demonstration especially relevant for informing other integrated programs for seniors and people with disabilities.

Keywords: Duals Demonstration; Duals Special Needs Plans; Managed Care - Medicaid < Managed Care; Managed Care - Medicare < Managed Care; Managed Long Term Services and Supports.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • California
  • Continuity of Patient Care
  • Disabled Persons / statistics & numerical data*
  • Female
  • Humans
  • Long-Term Care*
  • Male
  • Managed Care Programs / statistics & numerical data*
  • Medicaid / statistics & numerical data*
  • Medicare / statistics & numerical data*
  • Middle Aged
  • Patient Satisfaction
  • Quality Improvement
  • United States