The Department of Health Care Services announced this week that the Cal MediConnect duals demonstration project will not start until at least January, 2014, a delay from its previous expected launch date in October, 2013.
Advocates for seniors’ health care yesterday praised the decision, saying the extra three months will go a long way toward pulling all of the disparate pieces of Cal MediConnect into place.
“I think [the delay] comes from the general recognition that so many things have to happen, for so many people, speaking so many languages,” said Jack Hailey, project manager for Government Action and Communication Institute, and a contributor to the California Collaborative for Long Term Services and Supports.
The Cal MediConnect duals demonstration program affects about 456,000 Californians who are dually eligible for Medicare and Medi-Cal coverage in eight demonstration counties. State officials expect combining services and funding provided by Medicare and Medi-Cal will provide better, more coordinated care for seniors and save the state money.
At one point, Hailey said, the health plans were supposed to have IT systems in place by the start of June, a feat he characterized as “a pretty Herculean effort,” he said.
“Among the initial challenges are having the systems to track beneficiariies, having a [health plan] rate that encourages comprehensive care to beneficiaries, plus the providers have to know they’re going to get paid, and paid properly,” Hailey said. “We’re still building provider groups. Plans are getting used to building wider provider networks. That takes time.”
Trying to reach the fragile dual-eligible population and explain the benefits and changes they might see in Cal MediConnect is a big hurdle, Hailey said, that will be helped by additional time.
“For us, it’s a big plus, because there are so many moving parts,” Hailey said. “We’ve been working on all kinds of [outreach] things with community groups and the counties.”
Hailey said the outreach effort has been hindered by lack of money, “but that’s not first and foremost,” he said.
“Health plans are still negotiating their rates. That’s clearly a big mountain to climb. There are the IT systems, provider networks, and then you get into plan readiness,” Hailey said. “Besides telling people about it, there are just so many things that go into it, so people can be told about it.”