California Pilot Offers Caveats For Moving ‘Dual Eligibles’ to Managed Care

As federal officials evaluate state proposals to move millions of the nation’s poorest and sickest individuals into managed care plans, they might consider a recent report from the California HealthCare Foundation.

The report analyzed California’s year-long transition of 240,000 low-income seniors and people with disabilities from fee-for-service plans into managed care as part of a federally approved demonstration project. Beneficiaries had to pick a managed care plan, or the state assigned one to them.
Despite efforts by state and health plan officials to smooth the transition, caregivers and others reported “the managed care system … was not prepared” to care for the population’s specific needs, which include complex cases involving mental illness, homelessness and developmental disabilities, the report said.