New Research: Care Coordination and Its Impact on Beneficiary Access to Health Care Services

UC Berkeley’s Health Research for Action and the Community Living Policy Center released a research brief examining the implementation of the Cal MediConnect (CMC) care coordination benefit. Results indicate that care coordination activities increase collaboration between providers and could improve access to community-based services, but further clarification about roles and benefits is needed for providers to be most effective.

The brief was supported by The SCAN Foundation as part of an ongoing evaluation of CMC, a demonstration to test Medicare-Medicaid integration in California. These latest findings build upon information from previous reports.

Researchers interviewed 94 health system stakeholders, including CMC plans, physicians, provider groups, hospitals, long-term care (LTC) facilities, and home- and community-based services (HCBS) providers.

Some of the key findings include:

  • Care coordination improved as health plans built internal care management capacity and connected with HCBS, but care coordination still varied in how it was implemented. The number of care coordinators increased as a result of the Coordinated Care Initiative, and care coordinators’ presence on the Individualized Care Team (ICT) encouraged a team approach.
  • ICTs helped promote care coordination across sites and ICT meetings proved effective at bringing all of a person’s providers, social service workers, and care coordinator together. These meetings were either in-person, at regular intervals to check patient progress, or on-the-spot problem-solving teleconferences. The meetings improved communication and provider collaboration, but ICT participants found it difficult to engage members.
  • The study found that care coordination could improve care transitions at the health plan, care facility, and home- and HCBS agency level. However, the reported improvements varied and could further improve through communication about CMC plan roles.
  • Care coordination efforts improved HCBS collaboration with CMC health plans, In-Home Supportive Services (IHSS), and Community-Based Adult Services (CBAS). Some plans transitioned beneficiaries out of long-term care facilities to community-based care settings, cutting costs in the process. While some HCBS organizations reported contracts and referral relationships with CMC plans, many reported problems with a lack of plan collaboration and underuse of HCBS organizations’ established relationships.

The research brief also gave recommendations about strengthening collaboration, clarifying the care coordination process, and predicting future health system workforce needs. Click here to read the research brief.

To learn more about this and other CCI evaluation efforts, visit: http://www.TheSCANFoundation.org/evaluating-medicare-medicaid-integration.

To learn more about Medicare-Medicaid integration evaluation efforts, visit http://calduals.org/background/cci/evaluations/

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