DHCS Delays Dual Eligibles Project
Just weeks after it announced a demonstration project to better manage the care for hundreds of thousands of Californians enrolled in both the Medi-Cal and Medicare programs, the Department of Health Care Services has delayed its implementation by at least 90 days.
DHCS Director Toby Douglas announced on Monday that the program, known as Cal MediConnect, will not commence until January 2014 at the earliest.
“Cal MediConnect is an opportunity to support people who have Medicare and Medicaid with more coordinated care,” Douglas said in an email to program participants, which included hospitals, clinics and health plans. “Doing so requires work on multiple levels between governments, health plans, and communities. This kind of systematic change takes time. We have decided to move the start date to give every issue the full consideration it deserves.”
Few specifics on what is causing the delay were available. Douglas was unavailable for an interview on Wednesday.
DHCS spokesperson Norman Williams said that Cal MediConnect’s “foundation is built by input from committed stakeholders. There are several areas where work is ongoing, including how we conduct outreach to beneficiaries, how we educate community groups, and how we develop health plan provider networks. We’re working diligently on further analysis of these issues to ensure a successful program.”
The Centers for Medicare and Medicaid Services approved the pilot project on March 27, with enrollment planned to begin on Aug. 1 and operations beginning on Oct. 1. Cal MediConnect would migrate 456,000 dual eligible Medicare and Medi-Cal enrollees living in Alameda, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo and Santa Clara counties into managed care programs that would provide all aspects of care. Los Angeles County, the state's most populous, would cap enrollment to 200,000. Although dual eligibles have the option of not being enrolled in managed care, residents in those counties would be automatically enrolled unless they object.
The project, which is intended to run through 2016, was scaled back considerably from its original proposal, which would have enrolled dual-eligibles into managed care programs in all 58 California counties.
