California Healthcare Foundation Report on Dual-Eligible Demonstration Project

Focuing on Enrollment for Individuals with Disabilities to Managed Care

September 7, 2012

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The report also highlights the problems with the California HealthCare Foundation's Health Reform and Public Program's Initiative, including:

  • Beneficiaries "experienced anxiety due to confusion and concern over whether or not they would still be able to see their current primary care physician, specialists and mental health providers" as well as those who provided their prescriptions and medical equipment, according to providers, advocates and others who had contact with them.
  • Many had trouble understanding the complex written materials they received, and fewer than half of the health plans offered individual counseling or support to beneficiaries by telephone.
  • While most health plans reported that they trained staff to work with beneficiaries to provide "information, support and care coordination," stakeholders said this service should have been offered earlier in the transition period to managed care, rather than once beneficiaries were enrolled in a plan and needed medical care.
  • Health plans reported out-of-date contact information for many beneficiaries, and said they had difficulty recruiting fee-for-service providers to their networks.