The Centers for Medicare and Medicaid Services (CMS) released the first two evaluation reports containing early results of the Medicare-Medicaid Financial Alignment Initiatives, known as the dual eligible demonstrations. California’s demonstration is called the Coordinated Care Initiative (CCI).
CMS contracted with RTI International to conduct interviews, focus groups, and collect qualitative and quantitative data for the reports, this is the first in a series to be released over the course of the demonstrations. One report focuses on the first six months of the Washington managed fee-for-service demonstration. The second report, the Report on Early Implementation of the Demonstrations under the Medicare-Medicaid Financial Alignment Initiative (Early Implementation Report), looks more broadly at the first six months of demonstration operations in all seven states where the demonstration was live before May 2014, including California.
The Early Implementation Report describes the range of activities and early experiences in implementing these demonstrations and includes information about specific successes and challenges encountered. This report is a great resource for stakeholders who want to better understand CCI performance, particularly as compared to other states.
The Report particularly calls out work in California on the strength of our stakeholder engagement process, including significant stakeholder input on the revised Cal MediConnect notices, as well as the strength and independence of the CCI Ombudsman program:
“In California, the Ombudsman Program expanded its tasks beyond complaints and advocacy to include options counseling after it was inundated with calls on basic questions about the demonstration. It requested and received additional training on all aspects of the California demonstration from the National Senior Citizens Law Center (now Justice in Aging) to provide staff attorneys with comprehensive information. Training was critical during early implementation to broaden knowledge about managed care and the demonstration.”
Finally, the Report recognized California for its commitment to continually examining and trying to improve the program, as evidenced by the significant research underway thanks to the SCAN Foundation including the Field Research Corporation rapid cycle polling and the University of California CCI evaluation focus groups. Both will be helpful to California as we continue to work on opportunities for improvement as also outlined in the RTI report, including strengthening care coordination and educational materials for beneficiaries.
RTI will continue to work on comprehensive, annual reports specific to each demonstration state. California’s Department of Health Care Services (DHCS) is committed to transparency throughout the Duals Demonstration. While many of these findings are preliminary, they provide important information that we can use, together with health plans and stakeholders, to respond to challenges and further strengthen coordinated care for dual eligible beneficiaries under the demonstration.
We should be ranking these demonstration projects on their investment in preventive health approaches that improve population health and save money in the long run. That includes State Departments of Health Services that are willing to reimburse for Social Model support services that extend the Safety Net and prevent pre-mature institutionalization. The Minnesota Demonstration uses the Fully Integrated Dual Eligible (FIDE) SNP insurance product to purchase social model support services. We should be talking more about this approach.