Medi-Cal Moves All Dual Eligible Beneficiaries To Managed Care

On January 1, 2023, California Medicaid (Medi-Cal) beneficiaries who are dually eligible for Medicare, but not already enrolled in Medicaid managed care were transitioned from fee-for-service (FFS) to Medi-Cal managed care plans. The affected beneficiaries, about 325,000 individuals, live in 31 counties in the Bay Area, Central Valley, and Imperial County. These beneficiaries represent about 30% of the state’s dual eligible population.
The transition is part of the California Advancing and Innovating Medi-Cal (CalAIM) managed care delivery system and payment reforms. Prior to the transition, more than 70% of Medi-Cal dual eligibles . . .