Skip Ribbon Commands
Skip to main content

Medi-Cal's Coordinated Care Initiative (CCI): The Duals Demonstration  

California’s Medi-Cal and the Medicare programs are partnering to launch a three-year demonstration starting in June 2013 to promote coordinated health care delivery for beneficiaries who are dually eligible for both Medicare and Medi-Cal, “dual eligible beneficiaries.”

The duals demonstration is part of California’s larger Coordinated Care Initiative (CCI) that was enacted in July 2012 through SB 10361 and SB 1008.2

Pending federal approval, the CCI will be implemented in 2013 in eight counties: Alameda, San Mateo, Santa Clara, Los Angeles, Orange, San Diego, Riverside and San Bernardino.

Duals Demonstration Goals:

  • Coordinate State and Federal benefits to improve continuity of care and use a person-centered approach.
  • Maximize the ability of dual eligible beneficiaries to remain in their homes and communities.
  • Increase the availability and access to home-and community-based alternatives.
  • Preserve and enhance the ability of consumers to self-direct their care and receive high quality care.
  • Optimize the use of Medicare, Medi-Cal and other State/County resources.

 

As part of the planning for this significant effort, DHCS is committed to providing data and information that can inform stakeholders, ensure a smooth transition, and help contracting health plans ready their operations for some of Medi-Cal’s most vulnerable populations.

The reports and pivot tables included on this website provide users with a descriptive profile of the population that is potentially eligible for Medi-Cal's duals demonstration and the data sets allow users to further analyze the population.

Throughout this website and the documents presented, the terms CCI and CMS’ State Demonstration to Integrate Care for Dual Eligible Individuals 3 are synonymous and may be used interchangeably.  The CCI naming convention is used to discuss the demonstration in the context of Medi-Cal’s initiative to integrate care for dual eligibles that are eligible for Medicare Parts A and B and D and entitled to full scope Medi-Cal benefits.

CCI Population - Information and Data

    Medi-Cal's CCI Population: Combined Medicare and Medi-Cal Cost, Utilization, and Disease Burden (PDF)

This report provides a demographic profile of the population potentially eligible for Medi-Cal's CCI, presents cost and utilization statistics for that population, and describes the relevant disease burden and conditions treated.

   Medi-Cal Statistical Brief: Medi-Cal's CCI Population - Definitions and Estimated Counts (PDF)

This statistical brief defines Medi-Cal's CCI population and presents estimated population counts.

   Profiles of Medi-Cal's Fee-for-Service (FFS) CCI Population in the Eight Pilot Counties (PDF)

This supplemental report provides a snap-shot of the population potentially eligible for Medi-Cal's CCI in each of the eight pilot counties.  The data contained in this report pertains to beneficiaries participating in both Medicare and Medi-Cal's traditional FFS care models and living in one of the following counties: Alameda, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, or Santa Clara.

   CCI Population Cheat Sheet (PDF)

This document provides a definition for each of the five CCI populations and eligible counts.

   CCI Population Flow Chart (PDF)

This document provides a graphical presentation of the CCI populations within the context of the overall dual eligible population.

CCI Population - Datasets and Pivot Tables

This link navigates to a graphical overview of Medi-Cal’s CCI populations with links to specific data sets for:  the CCI population in the 58 counties – After Exclusions, CCI population in the eight counties, and the FFS CCI population in the eight pilot counties.                

Related Information

 

Notes

[1] SB 208 (10/19/2010) http://www.leginfo.ca.gov/pub/09-10/bill/sen/sb_0201-0250/sb_208_bill_20101019_chaptered.pdf. Added §14132.275 to the W&I Code to establish pilot projects for dual eligibles to receive a continuum of services and maximize coordination of benefits between the Medi-Cal and Medicare programs. The Pilot projects were to be established in up to four counties, and would include at least one county that provides Medi-Cal services via a two-plan model.

[2] SB 1008 (6/27/2012) http://www.leginfo.ca.gov/pub/11-12/bill/sen/sb_1001-1050/sb_1008_bill_20120627_chaptered.pdf.  Amended §14132.275.  No sooner than March 1, 2013, demonstration sites are to be established in up to eight counties, and include at least one county that provides Medi-Cal services via a two-plan model.

[3] DHCS, Proposal to the Center for Medicare and Medicaid Innovation, Coordinated Care Initiative: State Demonstration to Integrate Care for Dual Eligible Individuals, April 4, 2012, Draft for Public Comment.  http://www.dhcs.ca.gov/provgovpart/Documents/Duals/Proposal_Documents/Draft%20Demonstration%20Proposal%20040412.pdf

Permissions and Sourcing:

It is recommended that anything taken from this website be attributed to its original source. RASD includes suggested sources with each analytic product presented on this site.

 

RASD HOME

Last modified on: 10/12/2015 8:55 AM