Three Meetings To Address Duals Conversion

This week, the state begins a series of stakeholder meetings across California, all looking at different aspects of the ambitious task of converting more than one million people who receive both Medicare and Medi-Cal benefits — known as dual eligibles — to a more comprehensive model of care.

According to Peter Harbage, who has been leading the information-gathering component of the effort, this is an important month in the process. Now that the first wave of input has been solicited, the three meetings scheduled for December can dive deeper into the details.

“The main goal is to talk about the design of the duals demonstration project, so the state can get a better understanding what people believe the challenges and opportunities are, and what consumer protections need to be done,” Harbage said.

The three meetings start with this week’s stakeholder discussion of mental and behavioral health coverage Friday in Sacramento. The mid-December meeting in San Francisco will focus on consumer protection, and the third meeting at the end of the month in Los Angeles will deal with long-term care. The Department of Mental Health hosts a preliminary meeting examining community mental health services tomorrow in Sacramento.

All meetings are open to the public and will be webcast.

Harbage said a fourth element will need serious discussion: financing.

“That’s the fourth critical component,” Harbage said. “The three meetings look at the three main things we’re concerned with. But also, the financial model is important. How it’s structured will help delivery of care, but that’s not coming up this month.”

California is one of 15 states getting $1 million in federal money to design new ways of handling dual eligibles. Since federal and state money received by the same patients can be duplicative, the idea is to consolidate those funds so that beneficiaries could actually receive a greater range of services while the state saves money.

“We’re getting toward the middle step of the demonstration design now,” Harbage said. “Now we want to bring everyone together for a group conversation. These meetings are critical to hear from stakeholders, to help inform the state on their design of the duals demonstration project.”