Abstract
California is the most populous and one of the most racially diverse states in the country. To avert the potential problem of not covering enough medical services for the entire population, California integrated the services of Medi-Cal and Medicare and developed the Coordinated Care Initiative. California wishes to provide amalgamated and adequate health care options to its eligible beneficiary population. This prompts an important public policy question: is the California Coordinated Care Initiative the most efficient (cost effective) way to do this? To answer the above question, I drew on evaluations conducted by Research Triangle Institute, or RTI International (RTI). RTI contracted with Centers for Medicare and Medicaid Services (CMS) prior to implementation and is the basis for all evaluations and the official evaluator of the CMS Demonstrations. One of the advantages of the RTI evaluations is that they utilize the exact same surveys and observations for each state, as the core method to gather information from the programs. In addition to analyzing evaluations by RTI, I include responses from stakeholders I interviewed, based on my findings in the analysis. The individuals I had the pleasure of talking with include: Amber Christ, Senior Staff Attorney with Justice in Aging, Christian Griffith, Chief Consultant of the California State Assembly Budget Committee, Andrea Margolis, Consultant of California State Assembly, and two individuals who wished to remain anonymous, with combined experience in working in the non-profit sector as a health care advocate, and in state government in finance and legislation. My analysis illustrates that it is possible to successfully integrate health plans only if there is ample time to plan, put policies in place, and inform those affected prior to implementation. Based on discussions with those who work with the program or understand its components, as well as evaluations done on the integrated programs, if some parts of the integration had been handled differently, the CCI program may not have suffered such catastrophic issues with implementation.