Free Webinar Series The state of California is moving forward with implementation of the Coordinated Care Initiative (CCI), including the recently federally-approved dual eligible demonstration project, now known as Cal MediConnect. The CCI is currently set to begin on January … Continue reading
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April 10, 2013 Webinar Last week, the California Department of Health Services and the Centers for Medicare and Medicaid Services reached an agreement to implement a dual eligible demonstration that will transform the way Medicare and Medi-Cal services are delivered … Continue reading
(February 20, 2013) Over the past year, the conversation among advocates working on the dual eligible demonstrations has shifted from proposals and design to memorandum of understandings (MOUs) and implementation. With three state MOUs signed, a few states withdrawing, and … Continue reading
August 22, 2012 Webinar. Twenty-six states have submitted proposals to the Centers for Medicare and Medicaid Services (CMS) to integrate the delivery and financing of services for people that qualify for both Medicare and Medicaid (dual eligibles). CMS is in … Continue reading
The Medicare-Medicaid Coordination Office has issued guidance inviting states to issue proposals for integrating Medicare and Medicaid services. Some of these proposals intend to use passive enrollment (also known as “opt-out”) processes. Passive enrollment auto-enrolls individuals into a new health … Continue reading
On March 27, 2012 at a California Senate information hearing on In Home Supportive Services Integration into Medi-Cal Managed Care, Stephen Kaye presented a paper on the outcome measurements for managed LTSS. Read Managed Long-Term Services and Supports in California: … Continue reading
When building new models for serving dual eligibles, it is essential that those models provide adequate access to providers that are able to serve the unique needs of dual eligibles. In particular, measures of network adequacy need to take into … Continue reading
One risk of the dual eligible integration models is that new incentives will arise for plans and providers to deny needed care. To address this risk, enrollees should have access to an independent ombudsman who can provide individual assistance and … Continue reading
Different options can be used. In Medicaid managed care, Arizona pays plans a blended rate that incorporates nursing home and community based costs but gradually tilts to a greater percentage of community-based costs. In Minnesota, the state pays plans for … Continue reading
This will likely mean in most cases basing provider payments on Medicare rates since experience shows that current Medicaid rates, in many cases have led to critical provider shortages. A paper by United Health Center for Reform reported that approximately 49% … Continue reading