California Strives To Improve Coordination of Care for Dual Eligibles
Federal and state officials are seeking ways to control costs and coordinate health care for the dual eligibles, the Los Angeles Times reports.
About 1.1 million Californians qualify for both Medicare and Medi-Cal. Medi-Cal is California's Medicaid program.
About Dual Eligibles
Dual eligibles qualify for Medi-Cal based on their low-income status and qualify for Medicare if they are elderly or have a disability.
In 2009, dual eligible beneficiaries accounted for nearly 40% of Medi-Cal spending, but they comprised only 15% of the total number of beneficiaries.
Implications of Federal Reform
Federal health reform provisions aim to improve care coordination between the Medicare and Medicaid programs. The provisions also are designed to decrease the number of duplicate services that can increase costs.
California was one of 15 states awarded a $1 million federal grant to test methods of curbing costs that result from care coordination.
In 2013, the state plans to begin an initiative to shift several hundred thousand dual eligibles into managed care plans to provide all of their medical care.
State officials have said managed care plans will reduce health care spending statewide while making it easier for patients with complex care needs to receive care.
However, some health care advocates have expressed concern that the managed care plan option could limit beneficiaries' choice of physicians (Gorman, Los Angeles Times, 11/13).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.