California launches pilot program to improve care for those enrolled in Medi-Cal and Medicare

Mae Ryan/KPCC

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California health officials announced Wednesday that the state has won federal approval for a pilot program designed to improve health care quality and coordination for those enrolled in both Medicare and Medi-Cal. 

Right now, the more than 1.1 million low-income Californians eligible for both government health programs must navigate a labyrinth of rules, benefits and medical providers from each program. It’s an uncoordinated and complicated effort that often results in fragmented, substandard and costly health care,  especially for those with chronic health problems.

These double-enrolled people, known as "dual eligibles," are among those with the greatest need for health care, according to the California Department of Health Care Services.  They also generate the highest costs for the health care system, consuming nearly 25 percent of Medi-Cal spending, the department noted.  

State health officials say California's newly approved pilot program – called “Cal MediConnect” -- will for the first time integrate the care dual-eligible enrollees receive under one health plan. It is designed to help them become more involved in their medical decisions, it will provide new benefits - including vision and dental care – and in theory, it will save the system money.

California’s three-year test plan is one of five approved so far nationwide, says the Centers for Medicare & Medicaid Services.  It will launch in October 2013 and will initially serve about 465,000 Medicare-Medi-Cal enrollees in eight California counties.

Los Angeles County is expected to enroll  200,000 people during a 15-month period beginning in October, California Health and Human Services Secretary Diana Dooley told reporters Wednesday. 

The other counties chosen to participate in the pilot program are:  Orange, Riverside, San Bernardino and San Diego counties in southern California, and Alameda, Santa Clara and San Mateo counties in northern California.