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Other Resource
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)
Topic: Data for Medicare-Medicaid Integration
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Other Resource
The CalDuals website provides information on Cal MediConnect -- the capitated model Financial Alignment Initiative in California.
(California Department of Health Care Services)
Topic: Capitated Model
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Other Resource
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)
Topic: Capitated Model
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Brief
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
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Other Resource
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
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Brief
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)
Topic: Capitated Model, Grievances and Appeals
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Other Resource
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
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Brief
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
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Brief
This brief describes early efforts in four states to improve integration of behavioral health services for Medicare-Medicaid beneficiaries.
(Center for Health Care Strategies)
Topic: Behavioral Health, Behavioral Health
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Brief
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
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Other Resource
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
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Other Resource
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)
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Other Resource
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)
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Other Resource
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)
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Other Resource
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)
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Other Resource
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Other Resource
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)
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Other Resource
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)
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Other Resource
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)
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Other Resource
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)
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Other Resource
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)
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Brief
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)
Topic: Durable Medical Equipment (DME)
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Technical Assistance Tool
This resource reports data on the most recent 12 months of enrollment in the capitated model financial alignment demonstrations.
(Integrated Care Resource Center)
Topic: Enrollment
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Technical Assistance Tool
This resource reports data on the most recent 12 months of enrollment in capitated model demonstrations under the Financial Alignment Initiative.
(Integrated Care Resource Center)
Topic: Enrollment
