In 2014 California implemented a federal dual alignment demonstration that used a capitated managed healthcare model called Cal MediConnect (CMC) to integrate medical care and long-term services and supports (LTSS) for beneficiaries with both Medicare and Medicaid. These beneficiaries often have complex care needs, including multiple chronic conditions and disabilities. By 2016, 120,000 eligible beneficiaries were enrolled in the program.
Reports & Publications
The Better Care Reconciliation Act (BCRA) proposes to cap Federal Medicaid reimbursements to the states on a per-enrollee basis, effectively limiting growth to a rate at first only modestly exceeding the rate of inflation in healthcare costs and then falling below inflation. If the BCRA were to be enacted, it is reasonable to assume that most states would limit home and community-based services (HCBS) spending to the per-enrollee cap amount; otherwise, any excess comes entirely out of the state budget.
AN UPDATED VERSION OF THIS REPORT, BASED ON THE SENATE'S DRAFT BETTER CARE RECONCILIATION ACT, IS NOW AVAILABLE.
Abstract: This study examines health services appraisal (HSA) and unmet health-care needs for adults (age 50 and over) with physical disabilities in Medicaid managed care (MMC) versus Medicaid fee for service (FFS). Surveys from 309 individuals in MMC and 349 in FFS 2 years after MMC implementation included demographics, MMC processes, HSA, and unmet health-care needs.
As part of the University of California’s three-year evaluation of the Cal MediConnect (CMC) program, this research brief examines the efforts of CMC health plans to identify and transition members from long-term care institutions to home and community-based settings. Findings describe the progress many CMC plans have made in accelerating transitions out of institutional care, including successful strategies and challenges encountered in the process, as well as the barriers that still remain.