Today, researchers at the University of California (UC) San Francisco and UC Berkeley released new findings from their three-year evaluation of Cal MediConnect and the Coordinated Care Initiative.
The UC’s evaluation – funded by The SCAN Foundation – includes interviews with various stakeholders including Cal MediConnect health plans, provider groups, long-term care facilities, In-Home Supportive Services (IHSS), Multipurpose Senior Service Program (MSSP), Community Based Adult Services (CBAS), hospitals, state and federal government, and community based organizations. The study evaluates the impact of the Cal MediConnect on beneficiaries as well as the overall health system, identifies areas for improvements, and includes recommendations to better coordinate care for dual eligible beneficiaries.
DHCS appreciates the various evaluation efforts supported by The SCAN Foundation, and is encouraged by early evaluation data showing that beneficiaries in Cal MediConnect health plans are confident in and satisfied with their care.
The report credits Cal MediConnect for building stronger relationships between the plans and various stakeholders including providers, community organizations, and long-term services and supports. For the dual-eligible population, Cal MediConnect continues to provide a platform for increased collaboration among historically independent or ‘siloed’ programs and providers. The report identifies collaboratives as a key factor in promoting communication and shared learning, especially within large counties.
In addition, the study reported strong evidence of Cal MediConnect delivering on its promise of care coordination among the dual-eligible beneficiaries. It recognized Cal MediConnect’s success in developing and expanding innovative care coordination programs among the health plans. The report highlights the significant improvement in the “culture of care.”
The report also identifies several areas for improvement. DHCS and its partners recognize and are finding solutions for the challenges of integrating different health care systems so that care is coordinated and improved for all Cal MediConnect beneficiaries. DHCS appreciates the recommendations of this report, and will integrate this valuable information into new and ongoing projects to improve Cal MediConnect.
Critically, the report calls out the continued need to strengthen connections with long-term services and supports (LTSS), and DHCS is working on several fronts to address this concern. DHCS is taking several steps to encourage broader use of LTSS services. DHCS is working with stakeholders to standardize the Health Risk Assessment (HRA) questions designed to prompt referrals for non-medical or LTSS needs. Furthermore, we are strengthening data collection around LTSS referrals to better track how effectively plans are linking beneficiaries to needed services.
DHCS looks forward to continuing to work with plans and stakeholders to continue to strengthen the program.
UC Report & Key Findings and Recommendations:
Cal MediConnect – How Have Health Systems Responded? (Full Report)
Health System Response Key Findings and Recommendations
More information on various evaluation efforts:
http://www.thescanfoundation.org/evaluating-medicare-medicaid-integration.