Skip to main content
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Digital Health
    • Transformation
    • ESG
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Blogs
    • AI
    • Deals
    • Layoff Tracker
    • HIMSS 2023
  • Opinion
    • Breaking Bias
    • Commentaries
    • Letters
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Hospital at Home
    • - Workplace of the Future
    • - AI and Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Sponsored Video Series - One on One
    • Sponsored Video Series - Checking In with Dan Peres
  • Data & Insights
    • Data & Insights Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • Newsletters
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Government
January 17, 2017 11:00 PM

California's effort to coordinate care for people eligible for Medicare and Medicaid is in jeopardy

Virgil Dickson
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    AP Photo
    Gov. Jerry Brown

    California Gov. Jerry Brown's latest fiscal budget proposes ending a program that coordinates care for people enrolled in both Medicaid and Medicare next year. The program failed to show it saved money but because Gov. Brown believes it improved care, he's asking to continue with many aspects of it.

    Last week, Brown said his proposed budget for fiscal year 2017-2018 did not include funding for its Coordinated Care Initiative (CCI), despite the fact that the state is enjoying a surplus.

    The program, which began in 2012, had private insurers pay for managed long term services and supports to Medicaid beneficiaries and a demonstration that would coordinate care for people dual-eligible for both Medicare and Medicaid in an effort to provide less expensive, but better care.

    CCI was flagged for years as not being cost-effective and included a provision requiring the program be accessed for cost savings every year. If it failed, the program would be canceled the following year. If Gov.'s Brown budget is finalized, the program will end June 30.

    Brown said he'd like to preserve elements of the effort, including asking payers to continue to oversee benefits for dual-eligibles. Brown also hopes to continue the MLTSS program because it kept people in their homes instead of hospitals or nursing homes. In order to continue those services, new legislation would have to be drafted.

    "We are pleased that the governor's budget preserves the Cal MediConnect program, which allows us to continue to coordinate care and improve care outcomes and access for this fragile population," said Cherie Compartore, senior director of government affairs at L.A. Care Health Plan, a CCI plan.

    Currently, in most states, a person who is dual-eligible for Medicare and Medicaid is covered under one plan for Medicaid, while receiving fee-for-service Medicare. Thirteen states, however, have demonstrations that have one private payer in charge of all of that person's health benefits under an umbrella.

    “While the administration has indicated that it does not expect these changes to have any negative impact on beneficiaries, we will be monitoring this proposal,” said Linda Nguy, a policy advocate for the Western Center on Law and Poverty.

    The coordination of dual-eligibles is something a number of government agencies have aspired to as a way to curb costs for what is predominantly a chronically ill population that currently costs about $350 billion a year in federal and state spending to cover. The benefits of such coordination, however, have yet to be proven in any federal analysis.

    Charles Bacchi, CEO of the California Association of Health Plans, said in a statement that he's hopeful Brown will continue to push to coordinate physical, behavioral and social services under one umbrella.

    However, providers and plans are worried about one change likely to stick. Private payers will no longer offer home-supportive services benefits, such as the use of personal care attendants. Instead, local counties will provide those services under Brown's proposal.

    "This action does not support integrated services and care, as there would no longer be a single accountable entity, and it misaligns incentives for keeping people out of institutions, especially nursing homes,” said Maya Altman, CEO of Health Plan of San Mateo, one of the plans involved in CCI.

    The shift in responsibility could cost county governments an estimated $625 million next fiscal year and more than $4.4 billion over six years.

    “We undoubtedly would have to make cuts in other vital social services to cover these costs,” Keith Carson, president of the California State Association of Counties, said in a statement. “These services are required by both state and federal laws, so if the costs do fall on counties, we have to pay them, and we don't have the ability to raise the revenue we'll need to do so. That means cutting other critical local services.”

    Correction, January 19, 2017:

    This story was updated to correct and clarify the process by which California's Coordinated Care Initiative would be changed.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    congress prescription drugs
    PBMs, Big Pharma face off in House hearing
    Biden COVID copy_i_i.jpg
    Biden administration asks employers to help more workers who lose Medicaid
    Most Popular
    1
    CMS tries luring providers to revamped Medicare ACOs
    2
    Oregon joins other states in setting ratios for nurse staffing
    3
    Blue Shield CA taps Amazon, Mark Cuban, CVS for new PBM model
    4
    A health innovation hub grows in Lake Nona Medical City
    5
    Hospital-at-home providers push for Medicaid coverage
    Sponsored Content
    Modern Healthcare Alert: Sign up for this breaking news email to be kept in the loop as urgent healthcare business news unfolds.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Help Center
    • Advertise with Us
    • Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Digital Health
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • ESG
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Blogs
      • AI
      • Deals
      • Layoff Tracker
      • HIMSS 2023
    • Opinion
      • Breaking Bias
      • Commentaries
      • Letters
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - AI and Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Sponsored Video Series - One on One
      • Sponsored Video Series - Checking In with Dan Peres
    • Data & Insights
      • Data & Insights Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • Newsletters
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Jobs
      • People on the Move
      • Reprints & Licensing