Duals project sees additional setbacks

November 21, 2014

Last week the Department of Health Care Services (DHCS) announced more changes to the Cal MediConnect implementation timeline. Enrollment for the program in Alameda County will not move forward because of financial solvency issues with Alameda Alliance. In Orange County, enrollment will be delayed until August of 2015. This delay is the result of audits conducted by both Medicare and Medi-Cal that found deficits in CalOptima, a county organized health system that administers the Cal MediConnect program for beneficiaries in Orange County.

DHCS also released enrollment figures for Cal MediConnect last week showing a  little more than 100,000 dual eligible patients (almost one-fourth of eligible patients) have opted-out of the Cal MediConnect program. About 40 percent of those in the Los Angeles dual-eligible pool, which has the largest numbers of potential enrollees in the state, have opted out of the program.

According to the report, about 50,000 individuals have enrolled in the program so far. To see the rest of the enrollment numbers published by DHCS, click here.

Cal MediConnect 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 program begins with a three-year demonstration project that transitions a large portion of the state's dual eligible beneficiaries (eligible for both Medi-Cal and Medicare) to managed care plans. The project will impact approximately 450,000 duals in six counties (eight original counties –Los Angeles, Riverside, San Diego, San Mateo, San Bernardino, and Santa Clara.

Contact: Lishaun Francis, (916) 551-2554 or lfrancis@cmadocs.org.


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