Overview of California’s Duals Demonstration

Prepared for the Department of Health Care Services

October 2011 – California has approximately 1.1 million people enrolled in both Medicare and Medi-Cal, who are among the state’s highest-need and highest-cost users of health care services. The State is planning a demonstration for launch at the end of 2012 that will examine the benefits of coordinated care by enrolling a portion of dual eligibles into coordinated health care delivery models. Through this three-year demonstration, the State, in partnership with the Federal Government and California’s counties, aims to test how various models of patient-centered care delivery can improve beneficiary health and quality of life by reducing the fragmentation and inefficiencies in the existing fee-for-service system. By aligning financial incentives around the beneficiary, the demonstration hopes to drive coordinated and streamlined delivery of the full continuum of services that dual eligibles need, while better managing costs. The Department of Health Care Services will be seeking ongoing feedback on the demonstration to ensure adequate consumer protections are in place and that California remains a national vanguard in health care delivery innovation.