In September 2018, the University of California San Francisco (UCSF) Community Living Policy Center and the Institute for Health and Aging released findings from the Cal MediConnect (CMC) evaluation entitled, “Assessing the Experiences of Dually Eligible Beneficiaries in Cal MediConnect: Results of a Longitudinal Survey.” The evaluation assessed beneficiaries’ experiences over time, looking at specifics such as access, quality, and care coordination. Researchers conducted longitudinal telephone surveys in 2016 and 2017 with three groups of dually eligible beneficiaries: those enrolled in CMC, those who opted out, and those in non-demonstration (non-CCI) counties. Key findings include:
Care Coordination
- CMC beneficiaries with a care coordinator were nearly four times more likely to rate their care favorably when compared to those with no care coordinator. Conversely, beneficiaries who needed Long Term Services and Supports (LTSS) were less satisfied with their benefits and rated their quality of care as lower than those with no LTSS needs.
- Approximately 30% of CMC beneficiaries said that someone from a CMC plan helped them access specialty care. This response was more likely among those who had a care coordinator.
- Less than one third of CMC beneficiaries (31%) reported having a care coordinator. And half of CMC beneficiaries reported that they are receiving all the help they need with care coordination, while about a quarter said they could use more help with coordination.
Satisfaction with Plan Benefits
- 94% of CMC beneficiaries reported they were “very” or “somewhat” satisfied with their benefits.
- Three-quarters of CMC beneficiaries who used specialty care said it was easy to get appointments, while less than 10% reported problems getting approvals or referrals to specialists through their health plan.
- In 2016, 84% of CMC beneficiaries rated their quality of care as “excellent or good,” and this rating increased to 87% in 2017.
- CMC beneficiaries who received In-Home Supportive Services (IHSS) were almost 8 times more likely to rate their care excellent or good than those without IHSS.
- Half of non-English speaking CMC beneficiaries reported they could “never” get a medical interpreter when they needed one. Over 40% of CMC beneficiaries reported it was harder to get an interpreter in 2017 than it had been in 2016.
Hospital
- Between 2016 and 2017, there was a reduction of nearly 32% in reported emergency department use among CMC beneficiaries.
- Beneficiaries with a care coordinator were significantly more likely to have their CMC plan help with follow-up after leaving the hospital.