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Project Details

Evaluation of Cal MediConnect

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Project Summary: 

Evaluation of Cal MediConnect

The Coordinated Care Initiative is a federally funded demonstration program (pilot program) in California that combines Medicaid and Medicare services for people who qualify for both. This is expected to make care better and easier to get for beneficiaries, while saving money through administrative efficiencies. Health Research for Action is collaborating with the UCSF Community Living Policy Center and Institute for Health & Aging to evaluate California's dual financial alignment demonstration: Dually eligible beneficiaries often have a complex array of needs, including medical care, mental health care, and long-term services and supports. Health plans in seven California counties are offering adults who are eligible for both Medicare and Medi-Cal a new health plan called Cal MediConnect, which aims to coordinate medical, behavioral health, long-term institutional, and home- and community-based services through a single organized delivery system. Roughly 400,000 beneficiaries may be affected by the program. 

 

Methodology

Researchers from UC Berkeley's Health Research for Action are collaborating with researchers from UC San Francisco's Institute for Health & Aging. The evaluation includes focus groups and a longitudinal telephone survey with beneficiaries to examine their experiences with Cal MediConnect, as well as key informant interviews with stakeholders (including health plan representatives) to identify how the health system in affected counties has responded to the demonstration. Focus groups have been completed. The key informant interviews and telephone survey are ongoing.
 
The study also examines service-delivery system response to the initiative in several sectors, including health plans, medical care providers, behavioral health, skilled nursing, and home- and community-based services. The 3-year evaluation began in January 2015. It will gather information throughout the program period from:
  • Focus groups with beneficiaries who transitioned to Cal MediConnect
  • Telephone surveys with dually eligible beneficiaries at different points in time
  • Interviews with key health care and social service providers in the seven participating counties
 
The research team has worked closely with the California Department of Health Care Services and an expert advisory group, including stakeholders from a variety of sectors. 
Policy, Practice or Research Impacts: 

The California Department of Health Care Services has reviewed preliminary results of this evaluation. It has made several proposals for changes to the Cal MediConnect program, including:

  • Modifications to the health risk assessments, which mandates certain questions about unmet needs for long-term services and supports
  • Changes to the continuity of care provision, to allow beneficiaries to keep former providers up to 12 months after the transition
  • Updated guidebooks for both providers and beneficiaries, to explain how the program works in clearer language 
Contact Person: 
Carrie Graham
Contact Person's Email Address: 
clgraham@berkeley.edu
Department/Center: 
Health Research for Action
Principal Investigators: 
Carrie Graham
Partners: 
UCSF Community Living Policy Center
Location - States: 
CA
Location - Countries: 
USA
Publication Date: 
2016