California (demonstration transitioned 12/31/2022)

California Capitated Financial Alignment Model Demonstration (Cal MediConnect)

SPOTLIGHT & RELEASES

From March 2014 - December 2022, CMS and California partnered on a capitated financial alignment model demonstration called "Cal MediConnect." Under the demonstration, California and CMS contracted with Medicare-Medicaid Plans to coordinate the delivery of, and be accountable for, covered Medicare and Medicaid services for participating dually eligible individuals. Beginning in 2023, California expanded access to integrated care, including aspects of Cal MediConnect, through a new statewide infrastructure using exclusively aligned Medicare Advantage dual eligible special needs plans (D-SNPs). Cal MediConnect transitioned into the new statewide integrated care program.

More information on the new statewide integrated care program can be found at https://www.dhcs.ca.gov/provgovpart/Pages/Dual-Eligible-Special-Needs-Plans-in-CA.aspx. 

Archived documentation regarding the Cal MediConnect demonstration can be found below.

• Fact Sheet
• Three-way Contract (PDF)
  • Summary of Contract Changes (PDF)
• MOU (PDF)
• State Proposal (PDF)
• Third (Preliminary) Evaluation Report for the California capitated model demonstration under the Medicare-Medicaid Financial Alignment Initiative (04/12/2023)
  • Findings at a Glance
• Second (Preliminary) Evaluation Report for the California capitated model demonstration under the Medicare-Medicaid Financial Alignment Initiative (09/15/2021)
  • Findings at a Glance
• First Evaluation Report for the California capitated model demonstration under the Medicare-Medicaid Financial Alignment Initiative (11/29/2018)
• Readiness Review Tool (PDF)
• California Evaluation Design Plan (PDF)
• Letter of Intent to Extend Scheduled End Date (PDF)
• California Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 1 (PDF)
• California Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 2 (PDF)
• California Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 3 (PDF)
• California Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 4 (PDF)
• California Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 5 (PDF)
• California Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 6 (PDF)
• California Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 7 (PDF)
• California Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 8 (PDF)

Information from the state of California:

• Dual Eligibles Coordinated Care Demonstration - Cal MediConnect
• Cal Duals

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