November 02, 2015
Area(s) of Interest: Payor Issues and Reimbursement Public Payors
A statewide survey conducted by Field Poll found that many patients eligible for the Cal MediConnect program were reluctant to make changes to their health care and chose not to join the program. Nearly half of the low-income elderly Californians eligible for the program opted out, many because they feared losing their doctors.
The Cal MediConnect project was authorized by the state in July 2012 in an effort to save money and better coordinate care for the state’s low-income seniors and persons with disabilities. The state is in the middle of a three-year pilot project, conducted by the California Department of Health Care Services (DHCS) and aimed at nearly 500,000 of the state’s most costly patients – so called “dual eligibles.” These beneficiaries receive both Medicare, the health insurance program for seniors and the disabled, and Medicaid, or Medi-Cal in California, which provides coverage for the poor.
The survey research included 1,394 enrollees in the Cal MediConnect program in five California counties and 678 who opted out. Surveyors also interviewed 430 people in counties where the program is not being implemented. The poll was funded by The SCAN Foundation and done in conjunction with DHCS.
The top two reasons cited by dual eligible beneficiaries for opting out of the program are: "I was satisfied with my current health care services and didn't want to make any changes" (cited by 84 percent) and "I didn't want to risk losing my doctor" (71 percent).
The survey also found that nearly 30 percent of Cal MediConnect enrollees have been seeing their personal doctor for one year or less, compared to just 16 percent of dual eligibles who opted out of the Cal MediConnect program. More than one in four Cal MediConnect enrollees (28 percent) also say that the physician they consider to be their personal doctor is now different than the one they were seeing prior to enrolling in Cal MediConnect.
The survey was the first of four planned polls of dual eligibles in California.
Read the survey results here.