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Confused and concerned: Vulnerable "dual eligibles" react to managed care transition

January 15, 2014

  • UCLA Center for Health Policy Research
    This month, more than 450,000 elderly Californians in eight counties who are insured through both Medicare and Medi-Cal ("dual eligibles") will begin to be notified about their impending transition from fee-for-service into a new managed care program called Cal MediConnect. There are likely to be numerous challenges in reaching this vulnerable group of consumers, who tend to have multiple chronic illnesses and disabilities. The past experiences and future challenges of informing the affected population of the changes and their choices are detailed in a new Center policy note supported by The SCAN Foundation
     
    Specifically, the authors, who have been following a typical group of 37 dual eligibles for several years as part of the Center's ongoing "HOME" project, found that those who will be affected are often confused or concerned about the potential effects of any program change to their health care. Notices about the newest changes are just starting to be mailed out to consumers and most are not aware of the upcoming shift to managed care. But even when sent information about changes, this vulnerable group is often unable to fully understand the changes or act on options they are offered, particularly when they are in poor health or without family or other supportive resources.

    The participating counties are: Alameda; Los Angeles; Orange; Riverside; San Bernardino; San Diego; San Mateo; and Santa Clara.

    The study documents how these elderly adults would like to receive information and recommends strategies -- some gleaned from health care reform implementation -- that might smooth the transition.
     
     
    Read a related interview with lead author Kathryn Kietzman.

    Learn more about the HOME Project.