Feds Approve New Test to Cut Costs for Dual Eligibles

California has become the latest state to win approval for a demonstration of coordinated care for dual eligibles, the state Health and Human Services Agency announced last week.

For the next three years California will manage care for individuals who qualify for both Medicare and the state’s Medicaid program, Medi-Cal, under a new joint effort called “Cal MediConnect.” California joins Massachusetts, which became the first to win approval to test the capitation payment model for managing care of dual eligibles, and Washington, Illinois, and Ohio.

“Currently, these patients must navigate a fragmented system to find the services they need,” said Health and Human Services Secretary Diana Dooley in a statemtn. “Through the Cal MediConnect program, Californians will receive coordinated care that helps prevent them from falling through the cracks and ensures they have access to the right services at the right time.”

Dual-eligible patients in eight counties will have the option to enroll in the new managed care program. “The health plans selected to participate in the Cal MediConnect program will receive a blended monthly payment from Medi-Cal and Medicare to provide their enrollees all needed services through new health plan products. Beneficiaries will have a single health plan membership card and access to a care team to help coordinate their services,” according to the state’s press announcement.

The Governing blog has a comprehensive report on the California dual-eligible test program here.