Abstract
In 2014, California became one of 13 states to implement a financial and administrative alignment
demonstration called the Coordinated Care Initiative (CCI).1 In California, existing Medicare and
Medi-Cal (California’s Medicaid program) managed care health plans in seven counties created
new products called “Cal MediConnect” (CMC).2 In demonstration counties, beneficiaries eligible
for both Medicare and Medi-Cal, sometimes called “duals,” were passively enrolled into CMC plans,
with an option to opt out. Those who were enrolled received all Medicare and Medi-Cal benefits,
including both medical services and managed long-term services and supports (LTSS) through
a single capitated CMC health plan. CMC plans were also required to provide care coordination
services and coordinate behavioral health care.3,4 By September 2017, more than 116,000
dual beneficiaries were enrolled in CMC plans.5 To deliver these services, CMC plans developed
corresponding provider networks, including primary care providers (PCPs), provider groups,
federally qualified health centers (FQHCs), hospitals, and long-term care (LTC) providers.
Researchers from University of California conducted an evaluation of the impact of the CMC
program on beneficiaries and health systems.6 Data collected for this research brief built on
Phase I results and included 19 additional interviews with provider stakeholders including
physician providers, provider groups, CMC plan directors of provider networks, FQHCs, hospitals,
management services organizations (MSOs), and LTC providers