CMS Releases Cal MediConnect Evaluation Report

The Centers for Medicare & Medicaid Services (CMS) recently released its first formal evaluation report of the Cal MediConnect (CMC) demonstration. The report examines the CMC demonstration’s implementation and analyzes the program’s impact on beneficiary experience, quality, utilization and cost from April 1, 2014 through December 2016.

The extensive report evaluates the program using qualitative and quantitative data related to:

  • Integration of Medicare and Medicaid services;
  • Providing care coordination to enrollees;
  • Beneficiary enrollment;
  • Stakeholder engagement; and
  • Financing, payment, and Medicare savings

The report found that about one third of CMC enrollees received care coordination during the first seven demonstration quarters. These enrollees have provided positive feedback about this benefit and that their access to care and quality of life have improved.

The report was developed by CMS’ external evaluator, RTI International. RTI is tasked with evaluating all of the demonstrations under the Medicare-Medicaid Financial Alignment Initiative for CMS. RTI compiles data through a variety of means, including via informant interviews with the California Department of Health Care Services, CMC plans, beneficiaries, and other key CMC stakeholders. The report also features regression-based analysis of demonstration impact on utilization and Medicare Parts A and B costs for the demonstration-eligible population relative to a matched comparison group.

To review the entire report, click here.

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