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Home | Newsroom | Miscellaneous | California’s effort to coordinate care for people eligible for Medicare and Medicaid is in jeopardy

California’s effort to coordinate care for people eligible for Medicare and Medicaid is in jeopardy

California Gov. Jerry Brown’s latest fiscal budget proposes ending a program that coordinates care for people enrolled in both Medicaid and Medicare next year. The program failed to show it saved money but because Gov. Brown believes it improved care, he’s asking to continue with many aspects of it.

Last week, Brown said his proposed budget for fiscal year 2017-2018 did not include funding for its Coordinated Care Initiative (CCI), despite the fact that the state is enjoying a surplus.

The program, which began in 2012, had private insurers pay for managed long term services and supports to Medicaid beneficiaries and a demonstration that would coordinate care for people dual-eligible for both Medicare and Medicaid in an effort to provide less expensive, but better care.

CCI was flagged for years as not being cost-effective and included a provision requiring the program be accessed for cost savings every year. If it failed, the program would be canceled the following year. If Gov.’s Brown budget is finalized, the program will end June 30.

Brown said he’d like to preserve elements of the effort, including asking payers to continue to oversee benefits for dual-eligibles. Brown also hopes to continue the MLTSS program because it kept people in their homes instead of hospitals or nursing homes. In order to continue those services, new legislation would have to be drafted.

“We are pleased that the governor’s budget preserves the Cal MediConnect program, which allows us to continue to coordinate care and improve care outcomes and access for this fragile population,” said Cherie Compartore, senior director of government affairs at L.A. Care Health Plan, a CCI plan.

Currently, in most states, a person who is dual-eligible for Medicare and Medicaid is covered under one plan for Medicaid, while receiving fee-for-service Medicare. Thirteen states, however, have demonstrations that have one private payer in charge of all of that person’s health benefits under an umbrella.

“While the administration has indicated that it does not expect these changes to have any negative impact on beneficiaries, we will be monitoring this proposal,” said Linda Nguy, a policy advocate for the Western Center on Law and Poverty.

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