Cal MediConnect Quality and Data Reporting
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Under the Cal MediConnect (CMC) demonstration, health plans coordinated Medicare and Medi-Cal benefits for their members in seven counties: Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara. On January 1, 2023, Cal MediConnect plans transitioned to Medicare Medi-Cal plans (MMPs or Medi-Medi plans) provided by the same companies that provided Cal MediConnect plans. The below reflects the publicly available reports. If you need a report that is not listed below, please contact OMII@dhcs.ca.gov for assistance.
CMC Performance Quarterly Dashboards
The CMC Performance Quarterly Dashboard displays key Medicare and Medi-Cal metrics from the larger set of metrics that CMC plans report. Dashboard metrics include enrollment, care coordination, behavioral health and long-term services and supports utilization, and grievances and appeals.
Annual Quality Reports
This summary report presents the quality withhold results for Demonstration Years 1-8, which correspond to Calendar Years (CY) 2014-2022.
CMC Evaluation Outcome annual reports are summaries of monitoring activities and evaluations of the CMC demonstration using qualitative and quantitative data. Multi-year evaluations and studies referenced in this report include both CMC enrollee and dual-eligible (but not enrolled) beneficiary experience, quality, utilization, and cost analysis, in addition to provider and other key informant interview findings.
January 2019 Report
- Rapid Polling Project to quantify impact of CMC on California beneficiaries
- University of California Evaluation of CMC
January 2020 Report
- Summary of key findings through calendar year 2016 (published 2018) from the Research Triangle Institute (RTI) annual report.
- Rapid Polling Project to quantify impact of CMC on California beneficiaries
- University of California Evaluation of CMC
CMC Health Plan Quality and Compliance reports are annual compilations of various CMC-related monitoring and quality-related data. These reports include quality requirements such as the Healthcare Effectiveness Data and Information Set (HEDIS) results; Quality Withhold Summaries; highlights of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys; and summaries of plans' Performance Improvement Projects (PIPs).
Report January 2019
- Core quality withhold summaries for 2015 and 2016 which includes the following HEDIS measures:
- Plan all-cause readmissions
- Follow-up after hospitalization for mental illness
- Controlling blood pressure
- CAHPS survey results for 2016 and 2017
- Summary of PIPs from 2016 to 2018
Demonstration Year 2019
- Core quality withhold summaries for 2016 and 2017 which includes the following HEDIS measures:
- Plan all-cause readmissions
- Follow-up after hospitalization for mental illness
- Controlling blood pressure
- CAHPS survey results for 2019
- Summary of PIPs from 2016 to 2019
CMC Enrollment Status, Quality Measures, and State Costs reports are annual compilations of CMC enrollment status, activities, and quality measures which are derived from HEDIS standards from 2014 through 2019, in addition to budget-related data. The Managed Long-Term Services and Supports (MLTSS) monitoring items are the MCP measures that are used to monitor the MCPs fulfillment of their obligation to provide covered MLTSS such as in the CMC demonstration.
Report for FY 2018-2019; Released 2020
- Core quality measures available from 2014 to 2018
- Core quality withhold details and summary for 2016
- MLTSS monitoring items criteria
Report for Fiscal Year (FY) 2019-2020; Released April 2021
- Core quality measures available from 2014 to 2019
- Core quality withhold details and summary for 2017 and 2018
- MLTSS monitoring items criteria
