Office of Medicare Innovation and Integration
The Department of Health Care Services (DHCS) Office of Medicare Innovation and Integration (OMII) provides focused leadership and expertise on innovative models for Medicare beneficiaries in California, including Medicare-only beneficiaries, and individuals dually eligible for Medicare and Medi-Cal. The purpose of OMII is to improve health outcomes, quality, affordability, and equity for Medicare beneficiaries in California.
Consistent with the Governor’s Master Plan for Aging, OMII will: 1) Support new and existing models and strategies to benefit Medicare-only beneficiaries in California and increase access to Long-Term Services and Supports; and 2) Lead and advise on DHCS policies for beneficiaries dually eligible for Medicare and Medi-Cal. This includes the California Advancing and Innovating Medi-Cal (CalAIM) efforts to implement integrated care through aligned enrollment in Medicare Dual-Eligible Special Needs Plans (D-SNPs) and Medi-Cal plans, as well as expanded Managed Long-Term Services and Supports (MLTSS) for dually eligible beneficiaries.
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Data and Information
- Approximately 6.6 million Californians are enrolled in Medicare, including 5 million Medicare-only beneficiaries, and 1.6 million beneficiaries dually eligible for Medicare and Medi-Cal.
- Across all Medicare beneficiaries in the state, approximately 90 percent are age 65 and older, and 10 percent are under age 65. Among dually eligible beneficiaries in California, approximately 25 percent are under age 65.
DHCS is partnering with The SCAN Foundation and ATI Advisory to develop a series of chartbooks that provide information about Medicare beneficiaries in California. The first chartbook, Profile of the California Medicare Population is posted below.
- Under the California Advancing and Innovating Medi-Cal (CalAIM) Initiative, DHCS is expanding integrated care options and Managed Long-Term Services and Supports (MLTSS) for dually eligible beneficiaries. Please see the CalAIM MLTSS page for further details.
- The Budget Act of 2019 authorized funding for DHCS to contract with an actuarial firm to prepare a feasibility study and actuarial analysis of public long-term services and supports financing and services options for California. DHCS contracted with Milliman, which consulted with the state and stakeholders in California to gather information, priorities, and feedback for this study. The final report, which contains policy options and fiscal estimates, was completed in September 2020, and is posted on the DHCS website.
Medi-Cal Outreach & Enrollment for Older Californians: