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. Post-enrollment 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.
Reports & Publications
In January 2018, the Centers for Medicare and Medicaid Services (CMS) issued guidance that would allow states to use 1115 Waivers to add “work and community engagement” requirements for working-age Medicaid beneficiaries. This report examines the extent to which disability affects working-age Medicaid beneficiaries, and identifies the subset of beneficiaries with disabilities and work-limiting health conditions who would likely be exempt from proposed Medicaid work requirements or would benefit from modified requirements.
The decentralized nature of Home and Community-Based Services, and the fact that many HCBS providers travel to an individual’s home rather than service recipients traveling to provider facilities, have presented real difficulties for policymakers and advocates seeking to determine the most appropriate means of measuring network adequacy for LTSS providers. This report outlines multiple options that are available to state policymakers seeking to evaluate network adequacy for HCBS providers under MLTSS programs.
Researchers at the University of California conducted an evaluation of the implementation and impact of the CMC program on health systems and beneficiaries. This research brief examines the implementation of the new CMC care coordination benefit, including the progress made and challenges that remain in coordinating care for dual eligibles. Results are summarized from 94 key informant interviews with health system stakeholders.
Many people with disabilities who get paid help with daily activities also need help with health maintenance tasks, such as ostomy care, ventilator management, bowel and bladder care, tube feeding, insulin injections, and management of other medications. In many states, laws prohibit paid workers without nursing or other medical licenses from performing such tasks. In others, nurses are permitted to delegate such tasks to these workers. In some instances, such workers can perform health maintenance tasks under the direction of the consumer, without nurse delegation or supervision.