The CalDuals website provides information on Cal MediConnect -- the capitated model Financial Alignment Initiative in California.
(California Department of Health Care Services)
The most recent demographic, enrollment, and expenditure data for dually eligible beneficiaries is in the zip file "State and County Data File 2012" found on the Medicare-Medicaid Coordination Office website. Additional data and statistical resources for the years 2007, 2008, 2009, and 2011 can be found in the Medicare-Medicaid Enrollee State Profiles. See also Defining Medicare-Medicaid Enrollees in CMS Data Sources.
(Centers for Medicare & Medicaid Services)
These documents, including California's proposal, three-way contract, readiness review tool, and evaluation design plan, are posted on the Medicare-Medicaid Coordination Office's website.
(Centers for Medicare & Medicaid Services)
This blog describes pilot projects recently launched by six Cal MediConnect plans in Los Angeles and Orange County that will test interventions to reduce avoidable hospitalizations and other adverse events for nursing facility residents.
(California Department of Health Care Services)
This resource describes strategies used to communicate with consumers of California's In-Home Supportive Services program about the Cal MediConnect demonstration.
(Personal Assistance Services Council of Los Angeles County)
This video for potential Cal MediConnect enrollees shows what the passive enrollment letters and envelopes look like, guides beneficiaries through their enrollment options, explains integrated care, benefit of care coordinators care teams, and the supplemental benefits plans may offer, and highlights beneficiary protections.
(California Department of Health Care Services)
This webpage describes an initiative to redesign California's Medi-Cal stakeholder engagement process, including an online survey of stakeholders.
(California Department of Health Care Services)
This resource provides updated enrollment information, describes the state's response to administrative issues it has encountered, lists outreach efforts, budget issues, and other news.
(The SCAN Foundation)
This brief describes approaches that states have used to communicate early integrated care program results. Strategies discussed include developing program indicator dashboards, disseminating beneficiary experience data, and sharing success stories.
(Center for Health Care Strategies)
Topic: Capitated Model, Quality and Performance Measurement, Beneficiary Engagement, Counseling, and Support, Provider Engagement
This report documents the results of interviews with dually eligible individuals in California about how maintaining continuity of care may influence the success of the state's Cal MediConnect financial alignment demonstration program.
(UCLA Center for Health Policy Research)
This report describes beneficiary experiences with enrollment processes, communication about the model of care, and understanding of care coordination services under the capitated model financial alignment demonstrations.
(Medicaid and CHIP Payment and Access Commission)
Topic: Capitated Model, Beneficiary Engagement, Counseling, and Support
This report examines the contract requirements adopted by Medi-Cal, including a comparison with contracting recommendations made through an earlier multi-stakeholder collaborative process, and the state's rationale for contracting decisions.
(California HealthCare Foundation)
This brief explores opportunities for states to develop an integrated appeals process, whether through a D-SNP or a financial alignment demonstration.
(Center for Health Care Strategies)
This report examines the implementation of the expansion of California's Medicare managed care population to include seniors and people with disabilities.
(California Health Care Foundation)
This report describes early implementation activities occurring in the first six months of the seven financial alignment demonstrations launched as of May 1, 2014.
(RTI International)
Topic: Capitated Model, Managed Fee-for-Service Model
This presentation describes California's current stakeholder engagement process, plans for on-going advisory groups, and ways to solicit on-going feedback.
(California Department of Health Care Services)
This brief describes how three states - California, Ohio, and Virginia - are requiring Medicare-Medicaid Plans to stratify Medicare-Medicaid enrollees by their level of need within capitated financial alignment demonstrations.
(Center for Health Care Strategies)
Topic: Assessment, Care Planning, and Care Coordination
This brief describes how three states – California, Connecticut, and Illinois -- promote dually eligible beneficiaries’ access to durable medical equipment (DME) in a fee-for-service environment through the use of provisional prior authorization policies and online lists of DME that Medicare generally does not cover.
(Integrated Care Resource Center)
This brief describes early efforts in four states to improve integration of behavioral health services for Medicare-Medicaid beneficiaries.
(Center for Health Care Strategies)
Ombudsman programs can offer beneficiary protections as part of Medicaid managed care programs. These programs are particularly important for beneficiaries with complex physical and behavioral health conditions, including many dually eligible individuals. For the demonstrations under the Financial Alignment Initiative, the Centers for Medicare & Medicaid (CMS) and states incorporated ombudsman programs to help to resolve enrollees’ problems and alert Medicare-Medicaid Plans (MMPs), states, and CMS of emerging trends and issues. This technical assistance brief compares approaches that states took in structuring ombudsman programs and discusses the benefits and challenges of both models. It also examines the services offered by ombudsman programs and the value these programs have brought to the demonstrations. This brief is designed to help state Medicaid agencies that are developing beneficiary support systems or implementing new integrated care programs to better understand the full range of beneficiary needs within their dually eligible populations and how ombudsman programs or similar support systems could bring value to their efforts.
(Integrated Care Resource Center)
Topic: Financial Alignment Demonstrations, Beneficiary Engagement, Counseling, and Support
This webinar for California's Medi-Cal health plans highlights strategies for hiring and training care managers in integrated care programs.
(Center for Health Care Strategies)
Topic: Assessment, Care Planning, and Care Coordination
This brief examines how providers, health plans, and community-based organizations in three counties experienced California’s transition of approximately 240,000 seniors and people with disabilities to Medicaid managed care.
(Kaiser Family Foundation)
Topic: Background on Long-Term Services and Supports