Researchers at the University of California worked with a stakeholder advisory group to design an evaluation of Cal MediConnect (CMC), California’s dual financial alignment demonstration. It was decided that the evaluation should include qualitative interviews with stakeholders engaged in CMC to determine how the program has impacted the health system and how the system and stakeholders have responded to CMC.
Reports & Publications
Objective: We examined the health care utilization patterns of Medicare and Medicaid enrollees (MMEs) before and after initiating long-term care in the community or after admission to a nursing facility (NF).
Method: We used administrative data to compare hospitalizations, emergency department (ED) visits, and post-acute care use of MMEs receiving long-term care in California in 2006-2007.
Background: Many states are transitioning fee-for-service (FFS) Medicaid into Medicaid Managed Care (MMC) for people with disabilities. Objective: This study examined managed care's impact on health services appraisal (HSA) and unmet medical needs of individuals with disabilities receiving Medicaid. Key questions included 1) Do participant demographics and enrollment in MMC impact unmet medical needs and HSA? 2) Within MMC, do demographics and continuity of care relate to unmet medical needs? 3) Within MMC, do demographics, unmet medical needs and continuity of care relate to HSA?
Background: Individuals who receive long-term services and supports (LTSS) are among the most costly participants in the Medicare and Medicaid programs.
Objectives: To compare health care expenditures among users of Medicaid home and community-based services (HCBS) versus those using extended nursing facility care.
Medicaid’s current home and community-based services (HCBS) programs represent a 35 year incremental approach to system design. Since the early 1980s, Congress has amended the law numerous times, seeking to ameliorate the program’s institutional bias by creating new authorities and incentives for states to offer HCBS. While substantially increasing beneficiary access to HCBS, these initiatives also have resulted in a patchwork of options, contributing to administrative complexity for states and confusion for individuals seeking services.