Overall Los Angeles Riverside San Bernardino San Diego
Overall Los Angeles Riverside San Bernardino San Diego Findings from Waves 1 -4 of the Rapid Cycle Polling Project conducted for In conjunction with by November 2016 Field Research Corporation Orange Field Research Corporation, San Francisco, California San Mateo The California Department of Health Care Services Santa Clara The SCAN Foundation
Overall Santa Clara • By understanding the factors associated with eligible beneficiaries choosing to opt out of CMC. San Diego • By comparing CMC enrollees’ level of confidence and satisfaction with beneficiaries who chose to opt out of CMC or who live in non-CMC counties. San Bernardino • By assessing the confidence and satisfaction of CMC enrollees with the health services they are receiving. Riverside To evaluate and track over time the transitioning of beneficiaries to coordinated care under Cal Medi. Connect (CMC). Los Angeles Survey Objectives San Mateo Orange Field Research Corporation 1
Overall Data collection periods Santa Clara Wave 4 Survey: July – September 2016 Wave 3 Survey: February – April 2016 Wave 2 Survey: October – November 2015 Wave 1 Survey: June – September 2015 San Diego • • San Bernardino • Telephone interviews with stratified random samples of dual eligible beneficiaries in Cal Medi. Connect (CMC) counties, as well as beneficiaries in two non-CMC counties for control purposes. Riverside Survey method Los Angeles About the Surveys (1) Populations surveyed Field Research Corporation Orange • Waves 3 and 4 were expanded to also include CMC enrollees and opt outs in two additional counties (San Mateo and Orange) San Mateo • All Waves: CMC enrollees and opt-outs in 5 counties (Los Angeles, Riverside, San Bernardino, San Diego, and Santa Clara), and two non-CMC counties (San Francisco and Alameda) 2
Overall San Mateo Orange Field Research Corporation Santa Clara • CMC Enrollees: 6, 115 in total, including 1, 926 in Los Angeles, 838 in Riverside, 857 in San Bernardino, 802 in San Diego, 862 in Santa Clara, 526 in San Mateo and 304 in Orange. • CMC Opt-Outs: 3, 399 in total, including 1, 530 in Los Angeles, 426 in Riverside, 462 in San Bernardino, 412 in San Diego, 301 in Santa Clara, 130 in San Mateo and 138 in Orange. San Diego Sample Sizes Waves 1 - 4 (aggregated) San Bernardino • Wave 4: 3, 212 interviews, including 1, 647 CMC enrollees, 1, 005 CMC opt-outs, and 560 beneficiaries in non-CMC counties. • Wave 3: 3, 301 interviews, including 1, 704 CMC enrollees, 1, 026 CMC opt-outs, and 571 beneficiaries in non-CMC counties. • Wave 2: 2, 500 interviews, including 1, 370 CMC enrollees, 690 CMC opt-outs, and 440 beneficiaries in non-CMC counties. • Wave 1: 2, 502 interviews, including 1, 394 CMC enrollees, 678 CMC opt-outs, and 430 beneficiaries in non-CMC counties. Riverside Sample Sizes by Survey Wave Los Angeles About the Surveys (2) 3
Overall Los Angeles Riverside San Diego Santa Clara San Mateo Orange 4 Field Research Corporation San Bernardino Findings in Brief
Overall Findings in Brief Health care assessments of enrollees & opt-outs (1) Los Angeles Confidence in managing their health conditions Riverside San Diego Santa Clara San Mateo § The confidence levels expressed by opt-outs do not differ significantly from the confidence levels expressed by enrollees, and are generally similar to those reported by opt-outs in the first two survey waves. San Bernardino § Large majorities of enrollees continue to express confidence that they know how to manage their health conditions (83%), can get questions about their health needs answered (83%) and know who to call if they have a health need or question (84%). These findings are similar to the levels of confidence expressed by enrollees in Wave 3 earlier this year, but are somewhat higher that what enrollees reported in Waves 1 and 2 in 2015. Orange Field Research Corporation 5
Overall Findings in Brief Health care assessments of enrollees & opt-outs (2) Los Angeles Satisfaction with the health care services they are receiving Riverside Santa Clara San Mateo Orange Field Research Corporation San Diego § Large majorities of opt-outs in Wave 4 – ranging from 77% to 89% – are also satisfied with the health care services they are receiving across the same seven areas. The satisfaction levels of opt-outs are mostly similar to the findings observed among enrollees, although slightly larger proportions of opt-outs report being satisfied with their choice of doctors, their choice of hospitals and the amount of time their doctor and other staff spends with them. San Bernardino § Large majorities of enrollees – ranging from 76% to 86% – report being satisfied with the health care services they are receiving in each of seven areas tracked by the survey. Satisfaction levels are similar to those observed in Wave 3, but are higher than those observed in Waves 1 and 2 in several areas. These include satisfaction with their choice of doctors, the way different providers work together, and the information their health plan gives them to explain their benefits. 6
Overall Findings in Brief Health care assessments of enrollees & opt-outs (3) Los Angeles Problems encountered with their health care Riverside Santa Clara San Mateo Orange Field Research Corporation San Diego § Similar to prior waves, slightly more CMC enrollees than opt-outs mentioned in Wave 4 that a doctor they were seeing is not available through their health plan. However, similar to Wave 3, slightly fewer enrollees than opt-outs report that transportation problems prevented them from getting needed care in Wave 4. San Bernardino § Relatively small proportions of enrollees say they encountered any of six potential problems with their health services. The two most commonly reported problems are that a doctor they had been seeing was no longer available through their plan (19%) or that they had a misunderstanding about their health care services or coverage (16%). These proportions are similar to what was reported earlier this year in Wave 3, but tend to be lower than the proportions who reported these problems in earlier waves. 7
San Bernardino San Diego § The three most frequently cited reasons for not participating are that they were satisfied with current service/didn't want to make a change (86%), didn't want to risk losing their doctor (72%), or didn't want to risk losing their medicines (63%). Riverside The reasons given by opt-outs for choosing not to participate in Cal Medi. Connect in Wave 4 generally mirror those found in prior survey waves. Los Angeles Reasons given by opt-outs for not participating in CMC Overall Findings in Brief § Slightly less than half also say they didn't understand the information they received enough to make the change (46%) or thought their benefits or services might be reduced (44%). Santa Clara § Relatively few (16%) report that their doctor or other health provider recommended that they not participate in the program. San Mateo Orange Field Research Corporation 8
San Bernardino San Diego Santa Clara § The Wave 4 survey also finds no differences between enrollees and optouts with regard to having a personal care plan. 2 Similar proportions of enrollees (36%) and opt-outs (38%) said they had such a plan, of whom about two in three maintained that having such a plan improved their care a lot. Riverside § No differences are observed in Wave 4 between enrollees and opt-outs with regard to their reported use of single care managers. 1 About one in three enrollees (34%) and opt-outs (34%) said they had a single care manager, of whom about two-thirds said that they felt having such a manager improves their care a lot. Los Angeles Reported use of single care managers and personal health plans by enrollees & opt-outs Overall Findings in Brief San Mateo 1. A single care manager was defined in the survey as a nurse or other helper from their health plan who serves as their main point of contact and can arrange all aspects of their care. Field Research Corporation Orange 2. A personal care plan was defined in the survey as a plan designed to take into account their health goals, needs and preferences. 9
San Mateo Orange Field Research Corporation Santa Clara The differences in hospitalization among enrollees and opt-outs are noteworthy, especially given that no significant differences in self-reported health status are observed between the two populations. However, compared to enrollees, opt-outs do include somewhat larger proportions of LTSS beneficiaries and those who use specialized equipment. San Diego § When examining the aggregated results from all waves of the study at the county level, lower levels of hospitalization are reported by enrollees than by opt-outs in three counties: Los Angeles, San Diego and Orange counties. San Bernardino § When examining the results of enrollees and opt-outs from all waves of the study, 24% of enrollees and 30% of opt-outs report having been an overnight patient at a hospital in the previous 12 months. Similar differences are observed when examining the results from the Wave 4 survey only. Riverside A somewhat smaller percentage of enrollees than opt-outs report having been an overnight patient in a hospital in the recent past. Los Angeles Reported hospitalization of enrollees and opt-outs Overall Findings in Brief 10
Orange Field Research Corporation San Mateo Note: The findings in these section are based on the aggregated results of enrollees and opt-outs across all four waves of the survey. Santa Clara Large majorities of both enrollees and opt-outs are people of color, with Latinos comprising the largest segment of both groups, accounting for 44% of enrollees and 43% of opt-outs. Just 26% of enrollees, and an even smaller proportion of opt-outs (22%), are white non-Hispanic. San Diego § Among opt-outs, Orange County has the highest proportion of women at 65%, while San Diego County has the lowest at 57%. San Bernardino § The highest proportion of female enrollees is found in San Mateo County, where 62% are women, while Los Angeles County has the lowest at 53%. Riverside Majorities of both enrollees and opt-outs are women. However, women comprise a slightly larger share of those who decided to opt-out of Cal Medi. Connect (60%) than those who are enrolled in the program (54%). Los Angeles Demographic characteristics of enrollees & opt-outs (1) Overall Findings in Brief 11
Orange Field Research Corporation San Mateo § Orange County beneficiaries tend to be older, with nearly half of its enrollees and opt-outs age 75 or older. San Bernardino County beneficiaries tend to be younger, with greater than four in ten enrollees and opt-outs under age 65, while only about one in four are age 75 or older. Santa Clara There are no significant differences between enrollees and opt-outs by age, with about a third of each population are under age 65, a third are age 65 -74, and another third are age 75 or older. However, some variations in the age distributions of beneficiaries are evident across the seven CMC counties. San Diego § Both Santa Clara and San Mateo counties have larger proportions of Asian American enrollees and opt-outs than do the other CMC counties. San Bernardino § Los Angeles County has the highest proportion of Latinos – 49% among enrollees and 44% among opt-outs. Riverside There are relatively large variations in the ethnic composition of enrollees and opt-outs across the seven CMC counties. Los Angeles Demographic characteristics of enrollees & opt-outs (2) Overall Findings in Brief 12
San Mateo Orange Field Research Corporation Santa Clara § There is relatively little variation about this by county, with majorities of enrollees and opt-outs in each county reportedly receiving such assistance. San Diego Greater than six in ten enrollees (62%) and opt-outs (63%) report receiving Supplemental Security Income assistance from the federal government. San Bernardino § There is relatively little variation across individual counties on this dimension. One exception is San Mateo County where about as many enrollees are college graduates (26%) as have not graduated from high school (28%). Riverside One of the more distinguishing demographic characteristics of dual eligible beneficiaries for both enrollees and opt-outs relates to their relatively low levels of educational attainment. Greater than four in ten enrollees and optouts have not graduated from high school, and another one in five have no more than a high school degree. Very few – 13% of enrollees and 14% of optouts – are college graduates. Los Angeles Demographic characteristics of enrollees & opt-outs (4) Overall Findings in Brief 13
Overall Los Angeles Riverside San Bernardino San Diego Santa Clara Overall Findings Across the Four Survey Waves San Mateo Orange Field Research Corporation 14
San Diego Santa Clara There are no significant differences between the confidence levels expressed by CMC enrollee and CMC opt-outs on each measure. San Bernardino These results are not statistically different from the levels of confidence expressed by enrollees in Wave 3, but are somewhat higher that what enrollees reported in the first two survey waves. Riverside Very large majorities of CMC enrollees in the Wave 4 survey continue to express confidence that they know how to manage their health conditions (83%), can get questions about their health needs answered (83%) and know who to call if they have a health need or question (84%). Los Angeles 1. CMC enrollee confidence in managing their health conditions Overall Findings San Mateo Orange 15
Overall Findings Table 1 W 4 W 3 W 2 W 1 W 4 W 3 W 1 83% 81% 79% 80% 84% 78% 84% 80% 84% 87% 82% 80% 84% 86% 80% 81% 84% 83% 86% 82% 84% 83% Orange W 2 87% 82% 87% San Mateo Know who to call if you have a health need or question (% yes) W 4 83% 81% 78% 81% Santa Clara Can get questions about your health needs answered (% confident) 83% 81% 77% 79% San Diego W 1 Non-CMC counties San Bernardino Know how to manage your health conditions (% confident) CMC opt-outs Riverside CMC enrollees Los Angeles Confidence that beneficiaries know how to manage their health conditions, can get their questions answered, and know who to call 16
San Diego Santa Clara San Mateo A slightly larger proportion of CMC opt-outs than enrollees in Wave 4 express satisfaction with the amount of time their doctor and other staff spend with them, their choice of doctors, and their choice of hospitals. San Bernardino Satisfaction levels expressed by CMC enrollees in Wave 4 are similar to those observed in Wave 3, but are slightly higher than the proportions who reported being satisfied in earlier waves in several areas. These include satisfaction with their of doctors, the way different providers work together, and the information their health plan gives them to explain their benefits. Riverside Large majorities of CMC enrollees in Wave 4 – ranging from 76% to 86% – report being satisfied with the health services they are receiving in each of seven areas. Los Angeles 2. CMC enrollee satisfaction with their health services Overall Findings Orange 17
Overall Findings Table 2 CMC opt-outs Non-CMC counties 89% 90% 86% 87% 88% 86% 88% San Bernardino San Diego W 4 W 3 W 2 W 1 81% 84% 73% 76% 81% 80% 78% 75% 78% 81% 79% 78% Your choice of doctors (% satisfied) W 4 W 3 W 2 W 1 83% 78% 77% 88% 83% 86% 85% 84% Your choice of hospitals (% satisfied) W 4 W 3 W 2 W 1 79% 81% 77% 76% 83% 85% 84% 82% 84% 86% Orange Information health plan gives explaining your benefits San Mateo W 4 W 3 W 2 W 1 Santa Clara Amount of time doctor/other staff spend with you 86% 87% 85% 83% Riverside CMC enrollees Los Angeles Satisfaction with different aspects of the health care services beneficiaries are receiving (1) 18
Overall Findings Table 2 W 4 W 3 W 2 W 1 W 3 N/A W 1 N/A W 2 81% 80% 77% 82% 79% 74% 76% 77% 76% N/A 74% N/A Orange N/A: Question not asked in Waves 1 or 2. W 4 78% 77% 76% 73% San Mateo Your ability to call a health provider regardless of the time of day 85% 84% 81% 83% Santa Clara How long you have to wait to see a doctor when you need an appointment 85% 84% 83% 78% 83% 82% 78% 77% San Diego W 1 Non-CMC counties San Bernardino The way different providers work together (% satisfied) CMC opt-outs Riverside CMC enrollees Los Angeles Satisfaction with different aspects of the health care services beneficiaries are receiving (2) 19
Santa Clara San Mateo Orange Similar to prior waves, slightly more CMC enrollees than opt-outs or beneficiaries in non-CMC counties mentioned in Wave 4 that a doctor they were seeing is not available through their plan. However, similar to Wave 3, slightly fewer enrollees than opt-outs report that transportation problems prevented them from getting needed care. San Diego The proportions citing each are similar to Wave 3, but tend to be lower than the proportions who reported these problems in earlier waves. San Bernardino The two most commonly reported problems encountered by CMC enrollees were that a doctor they had been seeing was no longer available through their plan (19%) and that they had a misunderstanding about their health care services or coverage (16%). Riverside Similar to prior survey waves, no single issue is cited in the Wave 4 survey by more than one in five CMC enrollees as a problem they encountered since changing over to Cal Medi. Connect. Los Angeles 3. Specific problems encountered by CMC enrollees with their health services Overall Findings 20
Overall Findings Table 3 W 4 W 3 W 2 W 1 W 4 W 3 W 1 16% 18% 22% 20% 17% 22% 23% 27% 17% 23% 18% 21% 13% 16% 16% 14% 16% 15% 17% 14% 15% 18% 15% Orange W 2 16% 17% 16% 20% San Mateo Was denied a treatment or referral for another service recommended by a doctor 16% 18% 21% 18% Santa Clara Had a misunderstanding about your health care services or coverage W 4 19% 20% 22% 23% San Diego W 1 Non-CMC counties San Bernardino A doctor you were seeing is not available through your plan CMC opt-outs Riverside CMC enrollees Los Angeles Specific problems encountered with health services in the past year (1) 21
Overall Findings Table 3 W 4 * Small sample base. W 3 W 2 W 1 9% 11% 13% 12% 11% 16% 14% 7% 10% 14% 11% 9% 9% 12% 5%* 12% 11% 13% Orange Health provider did not speak your language and no interpreter was available (among non. English speakers) W 1 San Mateo W 4 W 2 14% 18% 14% 17% Santa Clara Had trouble communicating with a health provider because of a speech, hearing or other disability W 3 16% 15% 17% 13% 11% 15% 13% San Diego W 4 Non-CMC counties San Bernardino Transportation problems kept you from getting needed health care CMC opt-outs Riverside CMC enrollees Los Angeles Specific problems encountered with health services in the past year (2) 22
72% Didn't want to risk losing my doctor 46% Didn't understand the information I received about the new program enough to make the change Orange 44% Thought my benefits and services might be reduced San Mateo In addition, slightly less than half of the opt-outs also report these two other reasons for not participating: Santa Clara 63% Didn't want to risk losing any of my medicines San Diego 86% Satisfied with my current health service/ didn't want to make a change San Bernardino The three most frequently cited reasons continue to be: Riverside The reasons given by opt-outs in the Wave 4 survey for choosing not to participate in Cal Medi. Connect are very similar to what has been reported in prior survey waves. Los Angeles 4. Reasons CMC opt-outs give for choosing not to participate in Cal Medi. Connect Overall Findings 23
Overall Findings Table 4 Los Angeles Reasons CMC opt-outs give for choosing not to participate in Cal Medi. Connect Riverside W 3 88% W 2 86% W 1 84% W 4 72% W 3 73% W 2 70% W 1 71% 63% W 3 63% N/A W 1 N/A: Question not asked in Waves 1 or 2. My doctor/other health provider recommended that I not participate 46% W 3 46% W 2 48% W 1 46% W 4 44% W 3 45% W 2 40% W 1 37% W 4 16% W 3 17% W 2 16% W 1 20% Orange W 2 Thought my benefits and services might be reduced W 4 San Mateo W 4 Didn’t understand the information I received about the new program enough to make the change Santa Clara Didn’t want to risk losing any of my medicines 86% San Diego Didn’t want to risk losing my doctor W 4 San Bernardino Satisfied with my current health care services/ didn’t want to make a change 24
San Bernardino San Diego Santa Clara San Mateo Orange § Majorities of both enrollees and opt-outs are women, although women constitute a slightly larger proportion of opt-outs (60%) than enrollees (54%). § A large majority of both CMC enrollees and opt-outs are people of color. For example, among enrollees 44% are Latino, 12% African American and 11% Asian American, while just 26% are white non-Hispanic. The distributions are similar among opt-outs with 43% Latino, 13% African American and 13% Asian American. Just 22% of opt-outs are white non. Hispanic, a slightly smaller proportion than is observed among enrollees. § About two-thirds of both enrollees and opt-outs are age 65 or older, while about one in three are under age 65. Among beneficiaries over age 65 about half are between ages 65 and 74 and about half are age 75 or older. Riverside To increase the reliability of the estimates, all four waves of the survey were combined when comparing the demographic characteristics of enrollees to those who chose not to participate in Cal Medi. Connect in the CMC counties. The following are the demographic characteristics of each population: Los Angeles 5. Demographic characteristics of enrollees and opt-outs across the seven CMC counties (1) Overall Findings 25
Overall Findings Table 5 46% Female 54% 40% 60% 32% 65 -74 34% 33% 75 or older 33% 35% 26% Latino 22% 44% 43% 12% 13% Asian American 11% 13% Other/not reported 7% 9% Note: Percentages shown are the combined totals for enrollees and opt-outs in CMC counties across all survey waves. Orange African American San Mateo Race/ethnicity White non-Hispanic Santa Clara 33% San Diego Age Under 65 San Bernardino Gender Male CMC opt-outs Riverside CMC enrollees Los Angeles Comparing the demographic characteristics of enrollees and opt-outs in CMC counties (1) 26
San Bernardino San Diego Santa Clara § Nearly two-thirds of both enrollees (62%) and opt-outs (63%) report receiving Supplemental Security Income assistance benefits from the federal government. Riverside § One of the more distinguishing demographic characteristics of both enrollees and opt-outs in the CMC counties relates to their relatively low levels of educational attainment. Among both groups over four in ten have not graduated from high school, while another one in five have no more than a high school degree. Very few – 13% of enrollees and 14% of optouts – are college graduates. Los Angeles 5. Demographic characteristics of enrollees and optouts across the seven CMC counties (2) Overall Findings San Mateo Orange 27
Overall Findings Table 5 Not a high school graduate 41% 42% 22% 19% Some college/trade school 21% 20% 13% 14% Santa Clara College graduate San Diego High school graduate San Bernardino Education CMC opt-outs Riverside CMC enrollees Los Angeles Comparing the demographic characteristics of enrollees and opt-outs in CMC counties (2) Receive Supplemental Security Assistance benefits No 62% 29% 63% San Mateo Yes 27% Orange Note: Differences between 100% and the sum of percentages for each characteristic equal proportion not reporting an answer. 28
San Mateo Orange § A slightly larger proportion of opt-outs (30%) than enrollees (24%) say they have been an overnight patient in a hospital in the past 12 months. Santa Clara § More opt-outs (52%) than enrollees (48%) also report using specialized equipment, such as a cane, wheelchair, scooter or special bed. San Diego § Among opt-outs 45% include LTSS beneficiaries who require assistance for common daily activities. This compares to 40% among CMC enrollees. San Bernardino However, compared to enrollees, opt-outs include somewhat larger proportions of LTSS beneficiaries who require assistance for their common daily activities, those who use specialized equipment, or report having been hospitalized in the past year. Riverside No differences are observed in the self-reported health status of enrollees and opt-outs, with about half of enrollees (49%) and opt-outs (50%) saying they are in fair or poor health. Los Angeles 6. Health-related characteristics of enrollees and opt-outs across the seven CMC counties Overall Findings 29
Overall Findings Table 6 CMC opt-outs 50% Use specialized equipment, such as a cane, wheelchair, scooter or special bed 48% 52% Santa Clara Require assistance for common daily activities 40% 45% San Mateo 24% 30% Note: Percentages shown are the combined totals for enrollees and opt-outs in CMC counties across all survey waves. Orange Overnight patient in a hospital past 12 months San Diego 49% San Bernardino In fair or poor health Riverside CMC enrollees Los Angeles Comparing the health characteristics of enrollees and opt-outs in CMC counties 30
San Bernardino San Diego Santa Clara Conversely, in each survey wave fewer CMC beneficiaries than opt-outs or beneficiaries in non-CMC counties report having been with their personal doctor for 6 or more years. In Wave 4, 39% of CMC enrollees reported this, compared to 47% of opt-outs and 46% of beneficiaries in non-CMC counties. Riverside Similar to prior waves, larger proportions of CMC enrollees than opt-outs or beneficiaries in non-CMC counties report they have been seeing the doctor whom they consider their personal doctor for 1 year or less. However, the proportion of CMC enrollees reporting this in Wave 4 (22%) is lower than what was observed in Wave 1 (30%) and Wave 2 (28%). Los Angeles 7. Length of time beneficiaries have been going to their personal doctor Overall Findings San Mateo Orange 31
Overall Findings Table 7 40% 35% 30% 37% 33% 33% 27% 25% 22% 26% 25% 26% 18% 20% 22% 25% 20% 19% 23% 27% Note: Asked only of beneficiaries who report having a personal doctor. Differences between 100% and the sum of the percentages for each group equal proportion who could not give an estimate. Orange 18% 14% 13% 15% 17% 22% 18% 19% San Mateo More than 10 years W 4 W 3 W 2 W 1 21% 22% 21% 13% 19% 16% Santa Clara 6 -10 years W 4 W 3 W 2 W 1 36% 39% 35% 30% Non-CMC counties San Diego 2 -5 years W 4 W 3 W 2 W 1 22% 23% 28% 30% CMC opt-outs San Bernardino 1 year or less W 4 W 3 W 2 W 1 Riverside CMC enrollees Los Angeles Length of time beneficiaries have been going to the doctor they consider their personal doctor 32
San Bernardino San Diego In addition, similar proportions (about two-thirds) of those with single care managers across each beneficiary segment in Wave 4 say that having such a manager has improved their care "a lot. ” Riverside About one in three beneficiaries who are CMC enrollees, CMC opt-outs, or who live in non-CMC counties report in Wave 4 that they had a single care manager, such as a nurse or other helper from their health plan, who serves as their main point of contact and arranges all aspects of their care. Los Angeles 8. Beneficiaries' experiences with single care managers* Overall Findings Santa Clara San Mateo Orange * Single care manager described as “the person who serves as your main point of contact and arranges all aspects of your care. ” 33
Overall Findings Table 8 W 3 W 4 36% 34% 35% 34% 38% 34% 24 22 23 23 26 23 A little 6 7 7 Not at all 3 2 2 2 3 2 Not reported 3 3 3 2 2 2 Has a single care manager Has improved care… A lot San Mateo W 4 Santa Clara W 3 San Diego Non-CMC counties San Bernardino CMC opt-outs Riverside CMC enrollees Los Angeles Beneficiaries who report having a single care manager* (such as a nurse or other helper from their health plan) and its perceived impact on the quality of their care Orange * Single care manager described as “the person who serves as your main point of contact and arranges all aspects of your care. ” Note: Question not asked in Waves 1 and 2. 34
San Bernardino San Diego Across each segment about two-thirds of beneficiaries with personal care plans say that having such a plan has improved their care “a lot. ” Riverside Thirty-six percent of CMC enrollees report in Wave 4 that they have a personal care plan that takes into account their health goals, needs and preferences. This is not statistically different than the proportion of opt-outs reporting this (38%), but is slightly lower than what is reported by beneficiaries in the two non-CMC control counties (42%). Los Angeles 9. Beneficiaries' experiences with a personal care plan* Overall Findings Santa Clara San Mateo Orange * Personal care plan described as a plan designed to take into account your health goals, needs and preferences. 35
Overall Findings Table 9 W 3 W 4 33% 36% 38% 40% 42% 22 23 26 28 26 27 A little 7 9 7 5 8 9 Not at all 3 2 3 3 Not reported 1 2 2 2 3 3 Has a personal care plan Has improved care… A lot San Mateo W 4 Santa Clara W 3 San Diego Non-CMC counties San Bernardino CMC opt-outs Riverside CMC enrollees Los Angeles Beneficiaries who report having a personal care plan* and its perceived impact on the quality of their care Orange * Personal care plan described as a plan designed to take into account your health goals, needs and preferences. Note: Question not asked in Waves 1 and 2. 36
Overall Los Angeles Riverside San Bernardino San Diego Santa Clara Los Angeles County: Aggregated Results from Waves 1 -4 San Mateo Orange Field Research Corporation 37
Riverside San Bernardino San Diego Both CMC enrollees and opt-outs in Los Angeles County express similar high levels of confidence that they know how to manage their health conditions, can get questions about their health needs answered and know who to call of they have a health need or question. In each area, about eight in ten of both Los Angeles County enrollees and opt-outs express confidence in their ability to manage their condition. Los Angeles 1. CMC enrollee confidence in managing their health conditions in Los Angeles County Overall Los Angeles County Santa Clara San Mateo Orange 38
Overall Los Angeles County Table LA-1 CMC opt-outs 80% Can get questions about your health needs answered (% confident) 80% 79% Santa Clara 83% 84% San Mateo Know who to call if you have a health need or question (% yes) San Diego 79% San Bernardino Know how to manage your health conditions (% confident) Riverside CMC enrollees Los Angeles Confidence that beneficiaries know how to manage their health conditions, can get their questions answered, and know who to call Orange 39
§ How long you have to wait to see a doctor when you need an appointment (78% vs. 81%). Santa Clara § The way different providers work together (80% vs. 83%) San Diego § Choice of hospitals (78% vs. 83%) San Bernardino § Choice of doctors (81% among enrollees vs. 87% among opt-outs) Riverside While large majorities of CMC enrollees in Los Angeles County (between 77% and 87%) say they are satisfied with the health care services they are receiving in each of seven areas measured, slightly more CMC opt-outs than enrollees are satisfied in four areas. These include: Los Angeles 2. CMC enrollee satisfaction with their health services in Los Angeles County Overall Los Angeles County San Mateo Orange 40
Overall Los Angeles County Table LA-2 87% 89% 79% Your choice of doctors (% satisfied) 81% 87% San Mateo 78% 83% Orange Your choice of hospitals (% satisfied) Santa Clara 79% San Diego Information health plan gives explaining your benefits (% satisfied) San Bernardino Amount of time doctor/ other staff spend with you (% satisfied) CMC opt-outs Riverside CMC enrollees Los Angeles Satisfaction with different aspects of the health care services beneficiaries are receiving (1) 41
Overall Los Angeles County Table LA-2 CMC opt-outs How long you have to wait to see a doctor when you need an appointment (% satisfied) 78% 81% 77% 76% San Mateo Your ability to call a health provider regardless of the time of day* (% satisfied) Santa Clara 83% San Diego 80% San Bernardino The way different providers work together (% satisfied) Riverside CMC enrollees Los Angeles Satisfaction with different aspects of the health care services beneficiaries are receiving (2) Orange * Asked only in Waves 3 and 4. 42
San Bernardino San Diego Santa Clara When comparing the incidence of problems reported by enrollees to those of opt-outs, enrollees are somewhat more likely to report that a doctor they were seeing is not available through their plan. Riverside Relatively small proportions of enrollees and opt-outs in Los Angeles County say they encountered any of six specific problems relating to their health services in the recent past. The two most frequently mentioned problems, reported by about one in five of both groups are that a doctor they were seeing is not available through their plan or they had a misunderstanding about their health care services or coverage. Los Angeles 3. Specific problems encountered by CMC enrollees with their health services in Los Angeles County Overall Los Angeles County San Mateo Orange 43
Overall Los Angeles County Table LA-3 21% Had a misunderstanding about your health care services or coverage 12% 16% 11% 9% 10% Orange (among non- English speakers) 14% San Mateo Had trouble communicating with a health provider because of a speech, hearing or other disability Health provider did not speak your language and no interpreter was available 14% Santa Clara Transportation problems kept you from getting needed health care 22% San Diego Was denied a treatment or referral for another service recommended by a doctor 19% 18% San Bernardino A doctor you were seeing is not available through your plan CMC opt-outs Riverside CMC enrollees Los Angeles Specific problems encountered with health services in the past year 44
Riverside San Bernardino San Diego Majorities of opt-outs in Los Angeles County cite three main reasons for choosing not to participate in Cal Medi. Connect. These include being satisfied with their current health care services/didn't want to make a change (87%), didn't want to risk losing my doctor (74%) and didn't want to risk losing their medicines (62%). Slightly less than half also report not understanding the information they received about the new program (48%) or that they thought their benefits and services might be reduced (43%). Los Angeles 4. Reasons CMC opt-outs give for choosing not to participate in Cal Medi. Connect in Los Angeles County Overall Los Angeles County Santa Clara San Mateo Orange 45
Overall Los Angeles County Table LA-4 Los Angeles Reasons CMC opt-outs give for choosing not to participate in Cal Medi. Connect Riverside CMC opt-outs 87% Didn’t want to risk losing my doctor 74% San Diego Didn’t want to risk losing any of my medicines* 64% 48% 19% Orange * Asked only in Waves 3 and 4. 43% San Mateo Thought my benefits and services might be reduced Santa Clara Didn’t understand the information I received about the new program enough to make the change My doctor/other health provider recommended that I not participate San Bernardino Satisfied with my current health care services/didn’t want to make a change 46
San Bernardino On the other hand, women comprise a somewhat larger share of the opt-out population in Los Angeles County (60%) than they do of CMC enrollees (54%). Riverside About half of CMC enrollees in Los Angeles County are Latino (49%), a slightly larger proportion than is found in the opt-out population (44%). Los Angeles 5. Demographic characteristics of CMC enrollees and opt-outs in Los Angeles County Overall Los Angeles County Three in ten of both enrollees and opt-outs in Los Angeles County are under age 65, while 70% are age 65 or older. San Diego A large plurality of both CMC enrollees (45%) and opt-outs (44%) in Los Angeles County have not graduated from high school. Very small proportions are college graduates – 11% among enrollees and 14% among opt-outs. Santa Clara San Mateo Orange Greater than six in ten of CMC enrollees (61%) and opt-outs (63%) in the county say they receive Supplemental Security Income assistance benefits from the federal government. 47
Overall Los Angeles County Table LA-5 47% Female 53% 30% 65 -74 49% 14% 7% 15% 14% 9% Orange 11% 44% San Mateo 18% Santa Clara Other/not reported 37% 19% Latino Asian American 33% 34% Race/ethnicity White non-Hispanic African American 30% 36% 75 or older 60% San Diego Age Under 65 40% San Bernardino Gender Male CMC opt-outs Riverside CMC enrollees Los Angeles Comparing the demographic characteristics of CMC enrollees and CMC opt-outs (1) 48
Overall Los Angeles County Table LA-5 CMC opt-outs Not a high school graduate Some college/trade school 14% 11% 61% 30% 63% San Mateo Receive Supplemental Security Assistance benefits Yes No 19% Santa Clara College graduate 18% 22% San Diego High school graduate 44% 45% San Bernardino Education Riverside CMC enrollees Los Angeles Comparing the demographic characteristics of CMC enrollees and CMC opt-outs (2) 27% Orange Note: Differences between 100% and the sum of percentages for each characteristic equal proportion not reporting an answer. 49
San Diego Santa Clara San Mateo However, a slightly larger proportion of opt-outs (52%) than enrollees (48%) does report using specialized equipment, such as a cane, wheelchair, scooter or special bed or report requiring assistance for common daily activities (45% vs. 40%). San Bernardino This is noteworthy, especially since no statistically significant differences are observed in the self-reported health status of the two populations. About half of CMC enrollees (48%) and opt-outs (50%) in the county report being in fair or poor physical health. Riverside A somewhat smaller proportion of CMC enrollees (24%) than beneficiaries who opted out in Los Angeles County (31%) say they were an overnight patient in the hospital in the past 12 months. Los Angeles 6. Health-related characteristics of CMC enrollees and opt-outs in Los Angeles County Overall Los Angeles County Orange 50
Overall Los Angeles County Table LA-6 CMC opt-outs 50% Use specialized equipment, such as a cane, wheelchair, scooter or special bed 48% 52% Santa Clara Require assistance for common daily activities 40% 45% San Mateo 24% 31% Orange Overnight patient in a hospital past 12 months San Diego 48% San Bernardino In fair or poor health Riverside CMC enrollees Los Angeles Comparing the health characteristics of CMC enrollees and CMC opt-outs 51
Overall Los Angeles Riverside San Bernardino San Diego Santa Clara Riverside County: Aggregated Results from Waves 1 -4 San Mateo Orange Field Research Corporation 52
Riverside San Bernardino San Diego Both CMC enrollees and opt-outs in Riverside County express similar high levels of confidence that they know how to manage their health conditions, can get questions about their health needs answered and know who to call of they have a health need or question. In each area, greater than eight in ten of both Riverside County enrollees and opt-outs express confidence in their ability to perform these tasks. Los Angeles 1. CMC enrollee confidence in managing their health conditions in Riverside County Overall Riverside County Santa Clara San Mateo Orange 53
Overall Riverside County Table RIV-1 CMC opt-outs 81% Can get questions about your health needs answered (% confident) 83% 84% Santa Clara 86% San Mateo Know who to call if you have a health need or question (% yes) San Diego 81% San Bernardino Know how to manage your health conditions (% confident) Riverside CMC enrollees Los Angeles Confidence that beneficiaries know how to manage their health conditions, can get their questions answered, and know who to call Orange 54
San Diego § Amount of time the doctor or other staff spend with them (84% vs. 88%) San Bernardino § Choice of hospitals (77% among enrollees vs. 85% among enrollees) Riverside Large majorities of CMC enrollees in Riverside County (between 73% and 84%) say they are satisfied with the health care services they are receiving in seven areas measured. However, slightly larger proportions of CMC opt-outs than enrollees in the county report being satisfied in two areas. These include: Los Angeles 2. CMC enrollee satisfaction with their health services in Riverside County Overall Riverside County Santa Clara San Mateo Orange 55
Overall Riverside County Table RIV-2 CMC opt-outs Information health plan gives explaining your benefits (% satisfied) 82% 84% Your choice of doctors (% satisfied) 82% 84% San Mateo 77% 85% Orange Your choice of hospitals (% satisfied) Santa Clara 88% San Diego 84% San Bernardino Amount of time doctor/ other staff spend with you (% satisfied) Riverside CMC enrollees Los Angeles Satisfaction with different aspects of the health care services beneficiaries are receiving (1) 56
Overall Riverside County Table RIV-2 74% Santa Clara 78% 76% San Mateo Your ability to call a health provider regardless of the time of day* (% satisfied) 73% 83% San Diego How long you have to wait to see a doctor when you need an appointment (% satisfied) 81% San Bernardino The way different providers work together (% satisfied) CMC opt-outs Riverside CMC enrollees Los Angeles Satisfaction with different aspects of the health care services beneficiaries are receiving (2) Orange * Asked only in Waves 3 and 4. 57
Riverside San Bernardino Relatively small proportions of enrollees and opt-outs in Riverside County say they encountered any of six specific problems relating to their health services in the recent past. The two most commonly reported problems are that a doctor they were seeing is not available through their plan or that they had a misunderstanding about their health care services or coverage. Los Angeles 3. Specific problems encountered by CMC enrollees with their health services in Riverside County Overall Riverside County San Diego Santa Clara San Mateo Orange 58
Overall Riverside County Table RIV-3 21% 18% 20% Was denied a treatment or referral for another service recommended by a doctor 17% 18% * Small sample base. 11% 14% 12% 14%* Orange (among non- English speakers) 14% San Mateo Had trouble communicating with a health provider because of a speech, hearing or other disability Health provider did not speak your language and no interpreter was available 13% Santa Clara Transportation problems kept you from getting needed health care San Diego Had a misunderstanding about your health care services or coverage San Bernardino A doctor you were seeing is not available through your plan CMC opt-outs Riverside CMC enrollees Los Angeles Specific problems encountered with health services in the past year 59
San Bernardino San Diego Another 56% say they didn't want to risk losing any of their medicines, 49% didn't understand the information they received about the new program and 42% thought their benefits and services might be reduced. Riverside The two most commonly reported reasons opt-outs in Riverside County cite for choosing not to participate in Cal Medi. Connect are that they were satisfied with their current health care services/didn't want to make a change (85%), and didn't want to risk losing their doctor (68%). Los Angeles 4. Reasons CMC opt-outs give for choosing not to participate in Cal Medi. Connect in Riverside County Overall Riverside County Santa Clara San Mateo Orange 60
Overall Riverside County Table RIV-4 Riverside CMC opt-outs 85% 68% San Diego Didn’t want to risk losing any of my medicines* 56% 49% 11% Orange * Asked only in Waves 3 and 4. 42% San Mateo Thought my benefits and services might be reduced Santa Clara Didn’t understand the information I received about the new program enough to make the change My doctor/other health provider recommended that I not participate San Bernardino Satisfied with my current health care services/didn’t want to make a change Didn’t want to risk losing my doctor Los Angeles Reasons CMC opt-outs give for choosing not to participate in Cal Medi. Connect 61
San Mateo Orange Nearly two in three of CMC enrollees and opt-outs in the County (64%) say they receive Supplemental Security Income assistance benefits from the federal government. Santa Clara A plurality of CMC enrollees (44%) in Riverside County have not graduated from high school, and this increases to 50% among opt-outs. Very small proportions of beneficiaries in the County are college graduates – 9% among enrollees and 6% among opt-outs. San Diego Greater than four in ten enrollees in Riverside County are under age 65 (41%), 34% are age 65 -74 and 25% are age 75 or older. This differs slightly from the age distribution of opt-outs, of whom 36% are under age 65, 33% are age 65 -74 and 31% are age 75 or older. San Bernardino Women comprise a somewhat larger share of the opt-out population (60%) than they do of the county’s CMC enrollees (54%). Riverside Slightly less than half of CMC enrollees in Riverside County are Latino (45%), while among opt-outs, a 53% majority are Latino. Los Angeles 5. Demographic characteristics of CMC enrollees and opt-outs in Riverside County Overall Riverside County 62
Overall Riverside County Table RIV-5 46% Female 54% 41% 65 -74 34% 25% African American 31% 34% Latino 45% 10% 33% 29% 53% San Mateo Race/ethnicity White non-Hispanic 36% Santa Clara 75 or older 60% San Diego Age Under 65 40% San Bernardino Gender Male CMC opt-outs Riverside CMC enrollees Los Angeles Comparing the demographic characteristics of CMC enrollees and CMC opt-outs (1) 8% 5% 3% Other/not reported 6% 7% Orange Asian American 63
Overall Riverside County Table RIV-5 CMC opt-outs Not a high school graduate 6% 9% 64% 26% 64% San Mateo Receive Supplemental Security Assistance benefits Yes No 17% 16% Santa Clara College graduate 21% 24% San Diego High school graduate Some college/trade school 50% 44% San Bernardino Education Riverside CMC enrollees Los Angeles Comparing the demographic characteristics of CMC enrollees and CMC opt-outs (2) 27% Orange Note: Differences between 100% and the sum of percentages for each characteristic equal proportion not reporting an answer. 64
San Diego Santa Clara There are no differences in self-reported hospitalization of enrollees and optouts in the county, with slightly more than one in four enrollees (27%) and optouts (28%) reporting this. San Bernardino More than half of both enrollees (53%) and opt-outs (55%) also report using specialized equipment, such as a cane, wheelchair, scooter or special bed, and slightly less than half (45% among enrollees and 47% among opt-outs) require assistance in performing common daily activities. Riverside Similar majorities of CMC enrollees and opt-outs in the county (56% each) report being in fair or poor physical health. Los Angeles 6. Health-related characteristics of CMC enrollees and opt-outs in Riverside County Overall Riverside County San Mateo Orange 65
Overall Riverside County Table RIV-6 56% 53% Santa Clara Require assistance for common daily activities 45% 47% San Mateo 27% 28% Orange Overnight patient in a hospital past 12 months 55% San Diego Use specialized equipment, such as a cane, wheelchair, scooter or special bed 56% San Bernardino In fair or poor health CMC opt-outs Riverside CMC enrollees Los Angeles Comparing the health characteristics of CMC enrollees and CMC opt-outs 66
Overall Los Angeles Riverside San Bernardino San Diego Santa Clara San Bernardino County: Aggregated Results from Waves 1 -4 San Mateo Orange Field Research Corporation 67
Riverside San Bernardino San Diego When asked whether they are confident that they know how to manage their health conditions, 84% of enrollees and 82% of opt-outs say they are. While 82% of enrollees say they are confident that they can get their questions about their health needs answered, an even larger proportion of opt-outs (88%) report this. Similar large majorities of enrollees (86%) and opt-outs (84%) also say they know who to call if they have a health need or question. Los Angeles 1. CMC enrollee confidence in managing their health conditions in San Bernardino County Overall San Bernardino County Santa Clara San Mateo Orange 68
Overall San Bernardino County Table SB-1 CMC opt-outs 82% Can get questions about your health needs answered (% confident) 82% 88% Santa Clara 86% 84% San Mateo Know who to call if you have a health need or question (% yes) San Diego 84% San Bernardino Know how to manage your health conditions (% confident) Riverside CMC enrollees Los Angeles Confidence that beneficiaries know how to manage their health conditions, can get their questions answered, and know who to call Orange 69
San Bernardino San Diego § Amount of time their doctor or other staff spend with them (85% among enrollees vs. 90% among opt-outs) Riverside While large majorities of CMC enrollees in San Bernardino County (between 71% and 85%) are satisfied with the health care services they are receiving in each of the seven areas measured, slightly more CMC opt-outs than enrollees report being satisfied in three areas. These include: Los Angeles 2. CMC enrollee satisfaction with their health services in San Bernardino County Overall San Bernardino County § Choice of doctors (82% vs. 87%) Santa Clara § How long you have to wait to see a doctor when you need an appointment (71% vs. 77%) San Mateo Orange 70
Overall San Bernardino County Table SB-2 79% 90% 82% San Diego Information health plan gives explaining your benefits (% satisfied) 85% San Bernardino Amount of time doctor/ other staff spend with you (% satisfied) CMC opt-outs Riverside CMC enrollees Los Angeles Satisfaction with different aspects of the health care services beneficiaries are receiving (1) Santa Clara 82% 87% Your choice of hospitals (% satisfied) 81% 82% San Mateo Your choice of doctors (% satisfied) Orange 71
Overall San Bernardino County Table SB-2 77% Santa Clara 79% 78% San Mateo Your ability to call a health provider regardless of the time of day* (% satisfied) 71% 84% San Diego How long you have to wait to see a doctor when you need an appointment (% satisfied) 82% San Bernardino The way different providers work together (% satisfied) CMC opt-outs Riverside CMC enrollees Los Angeles Satisfaction with different aspects of the health care services beneficiaries are receiving (2) Orange * Asked only in Waves 3 and 4. 72
Riverside San Bernardino Relatively small proportions of enrollees or opt-outs in the county say they encountered any of six specific problems relating to their health services in the recent past. The two most commonly reported problems are that a doctor they were seeing was not available through their plan or that they had a misunderstanding about their health care services or coverage. Los Angeles 3. Specific problems encountered by CMC enrollees with their health services in San Bernardino County Overall San Bernardino County San Diego Santa Clara San Mateo Orange 73
Overall San Bernardino County Table SB-3 20% 17% 18% 15% Was denied a treatment or referral for another service recommended by a doctor 18% 14% * Small sample base. 14% 12% 11%* Orange (among non- English speakers) 11% 12% San Mateo Had trouble communicating with a health provider because of a speech, hearing or other disability Health provider did not speak your language and no interpreter was available 14% Santa Clara Transportation problems kept you from getting needed health care San Diego Had a misunderstanding about your health care services or coverage San Bernardino A doctor you were seeing is not available through your plan CMC opt-outs Riverside CMC enrollees Los Angeles Specific problems encountered with health services in the past year 74
San Bernardino San Diego Santa Clara In addition, slightly less than half cite as a reason that they did not understand the information they received about the new program (44%), while 38% thought their benefits and services might be reduced. Riverside Majorities of opt-outs in San Bernardino County cite three main reasons for choosing not to participate in Cal Medi. Connect. They include being satisfied with their current health care services/didn't want to make a change (86%), didn't want to risk losing their doctor (64%) and didn't want to risk losing their medicines (58%). Los Angeles 4. Reasons CMC opt-outs give for choosing not to participate in Cal Medi. Connect in San Bernardino County Overall San Bernardino County San Mateo Orange 75
Overall San Bernardino County Table SB-4 Los Angeles Reasons CMC opt-outs give for choosing not to participate in Cal Medi. Connect Riverside CMC opt-outs 86% Didn’t want to risk losing my doctor 64% San Diego Didn’t want to risk losing any of my medicines* 58% 44% 16% Orange * Asked only in Waves 3 and 4. 38% San Mateo Thought my benefits and services might be reduced Santa Clara Didn’t understand the information I received about the new program enough to make the change My doctor/other health provider recommended that I not participate San Bernardino Satisfied with my current health care services/didn’t want to make a change 76
San Mateo Orange About two in three of both CMC enrollees (66%) and opt-outs (65%) say they receive Supplemental Security Income assistance benefits from the federal government. Santa Clara Slightly fewer than four in ten CMC enrollees (39%) and opt-outs (38%) in San Bernardino County have not graduated from high school. Only 10% of each group are college graduates. San Diego A relatively large proportion of enrollees and opt-outs in the county are under age 65, comprising 44% of the County's enrollee population and 43% of all optouts. By contrast, only about a quarter of enrollees or opt-outs in the County are age 75 or older. San Bernardino Women comprise a somewhat larger share of the opt-out population in San Bernardino County (59%) than they do among CMC enrollees (54%). Riverside There about as many white non-Hispanics as Latinos among enrollees and opt-outs in San Bernardino County, with each group accounting for slightly more than a third of the total. Another 14%-15% are African American. Relatively few enrollees or opt-outs in San Bernardino County are Asian American. Los Angeles 5. Demographic characteristics of CMC enrollees and opt-outs in San Bernardino County Overall San Bernardino County 77
Overall San Bernardino County Table SB-5 46% Female 54% 44% 65 -74 32% 24% 35% African American Other/not reported 15% 5% 7% 36% 14% 5% 9% Orange Asian American 25% 38% Latino 32% San Mateo Race/ethnicity White non-Hispanic 43% Santa Clara 75 or older 59% San Diego Age Under 65 41% San Bernardino Gender Male CMC opt-outs Riverside CMC enrollees Los Angeles Comparing the demographic characteristics of CMC enrollees and CMC opt-outs (1) 78
Overall San Bernardino County Table SB-5 CMC opt-outs Not a high school graduate 38% 39% 25% 26% Some college/trade school 25% 22% 10% No 66% 26% 65% San Mateo Receive Supplemental Security Assistance benefits Yes Santa Clara College graduate San Diego High school graduate San Bernardino Education Riverside CMC enrollees Los Angeles Comparing the demographic characteristics of CMC enrollees and CMC opt-outs (2) 27% Orange Note: Differences between 100% and the sum of percentages for each characteristic equal proportion not reporting an answer. 79
San Bernardino Slightly less than half of enrollees (47%) and opt-outs (45%) say they require assistance for common daily activities. Riverside About half of CMC enrollees (52%) and opt-outs (53%) in San Bernardino County say they are in fair or poor physical health. Los Angeles 6. Health-related characteristics of CMC enrollees and opt-outs in San Bernardino County Overall San Bernardino County Similar proportions of enrollees and opt-outs in the county – about one in four – say they have been an overnight patient in a hospital in the past year. San Diego However, a slightly larger proportion of opt-outs (57%) than enrollees (51%) say they use specialized equipment, such as a cane, wheelchair, scooter or special bed. Santa Clara San Mateo Orange 80
Overall San Bernardino County Table SB-6 CMC opt-outs 53% Use specialized equipment, such as a cane, wheelchair, scooter or special bed 51% 57% Santa Clara Require assistance for common daily activities 45% 47% San Mateo 25% Orange Overnight patient in a hospital past 12 months San Diego 52% San Bernardino In fair or poor health Riverside CMC enrollees Los Angeles Comparing the health characteristics of CMC enrollees and CMC opt-outs 81
Overall Los Angeles Riverside San Bernardino San Diego Santa Clara San Diego County: Aggregated Results from Waves 1 -4 San Mateo Orange Field Research Corporation 82
San Bernardino San Diego Santa Clara Opts-outs are somewhat more likely than enrollees to say they are confident that they can get answers to questions they might have about their health needs. Riverside Both CMC enrollees and opt-outs in San Diego County express similar high levels of confidence that they know how to manage their health conditions, can get questions about their health needs answered and know who to call of they have a health need or question. In each area, about eight in ten of both enrollees and opt-outs express confidence in their ability to perform each task. Los Angeles 1. CMC enrollee confidence in managing their health conditions in San Diego County Overall San Diego County San Mateo Orange 83
Overall San Diego County Table SD-1 CMC opt-outs Can get questions about your health needs answered (% confident) 81% 86% Know who to call if you have a health need or question (% yes) 83% Santa Clara 82% San Diego 81% San Bernardino Know how to manage your health conditions (% confident) Riverside CMC enrollees Los Angeles Confidence that beneficiaries know how to manage their health conditions, can get their questions answered, and know who to call San Mateo Orange 84
San Mateo On the other hand, a slightly larger proportion of CMC enrollees than opt-outs in the county say they are satisfied with the information their health plan explaining their benefits. Santa Clara § The amount of time their doctor or other staff spends with them (84% vs. 88%) San Diego § Choice of hospitals (81% vs. 87%) San Bernardino § Choice of doctors (78% among enrollees vs. 86% among opt-outs) Riverside While large majorities of CMC enrollees in San Diego County (between 74% and 84%) say they are satisfied with the health care services they are receiving in each of seven areas measured, slightly fewer enrollees than opt-outs say they are satisfied in three areas. These include: Los Angeles 2. CMC enrollee satisfaction with their health services in San Diego County Overall San Diego County Orange 85
Overall San Diego County Table SD-2 84% 88% 74% Your choice of doctors (% satisfied) 78% 86% San Mateo 81% 87% Orange Your choice of hospitals (% satisfied) Santa Clara 79% San Diego Information health plan gives explaining your benefits (% satisfied) San Bernardino Amount of time doctor/ other staff spend with you (% satisfied) CMC opt-outs Riverside CMC enrollees Los Angeles Satisfaction with different aspects of the health care services beneficiaries are receiving (1) 86
Overall San Diego County Table SD-2 76% 81% 74% 76% Santa Clara San Mateo Your ability to call a health provider regardless of the time of day* (% satisfied) 83% San Diego How long you have to wait to see a doctor when you need an appointment (% satisfied) 80% San Bernardino The way different providers work together (% satisfied) CMC opt-outs Riverside CMC enrollees Los Angeles Satisfaction with different aspects of the health care services beneficiaries are receiving (2) Orange * Asked only in Waves 3 and 4. 87
Riverside San Bernardino San Diego Santa Clara Relatively small proportions of enrollees or opt-outs say they encountered any of six specific problems relating to their health services in the recent past. Most frequently mentioned are that a doctor they were seeing is not available through their plan or they had a misunderstanding about their health care services or coverage. In each case, about one in five enrollees and opt-outs report experiencing this problem. A third issue, that transportation problems kept them from getting need health care, is more likely to be mentioned by opt -outs than by enrollees. Los Angeles 3. Specific problems encountered by CMC enrollees with their health services in San Diego County Overall San Diego County San Mateo Orange 88
Overall San Diego County Table SD-3 Was denied a treatment or referral for another service recommended by a doctor * Small sample base. 13% 10% 13% 14% 19% 15% 9%* Orange (among non- English speakers) 18% San Mateo Had trouble communicating with a health provider because of a speech, hearing or other disability Health provider did not speak your language and no interpreter was available 23% Santa Clara Transportation problems kept you from getting needed health care 20% 19% San Diego Had a misunderstanding about your health care services or coverage 24% San Bernardino A doctor you were seeing is not available through your plan CMC opt-outs Riverside CMC enrollees Los Angeles Specific problems encountered with health services in the past year 89
Riverside San Bernardino San Diego Majorities of opt-outs in San Diego County cite three main reasons for choosing not to participate in Cal Medi. Connect. These include being satisfied with their current health care services/didn't want to make a change (82%), didn't want to risk losing their doctor (67%) or didn't want to risk losing any of their medicines (56%). Less than half also report not understanding the information they received about the new program (44%) or they thought their benefits and services might be reduced (40%). Los Angeles 4. Reasons CMC opt-outs give for choosing not to participate in Cal Medi. Connect in San Diego County Overall San Diego County Santa Clara San Mateo Orange 90
Overall San Diego County Table SD-4 Riverside CMC opt-outs 82% 67% San Diego Didn’t want to risk losing any of my medicines* 56% 44% 16% Orange * Asked only in Waves 3 and 4. 40% San Mateo Thought my benefits and services might be reduced Santa Clara Didn’t understand the information I received about the new program enough to make the change My doctor/other health provider recommended that I not participate San Bernardino Satisfied with my current health care services/didn’t want to make a change Didn’t want to risk losing my doctor Los Angeles Reasons CMC opt-outs give for choosing not to participate in Cal Medi. Connect 91
Orange § Greater than six in ten of CMC enrollees (65%) and opt-outs (63%) in the County say they receive Supplemental Security Income assistance benefits from the federal government. San Mateo § About one in three CMC enrollees (37%) and opt-outs (36%) in San Diego County have not graduated from high school, while relatively few are college graduates. Santa Clara § Slightly more than a third of each group are under age 65, about nearly two thirds of age 65 or older. San Diego § A majority of both enrollees (54%) and opt-outs (57%) are women. San Bernardino The enrollee and opt-out populations in San Diego County are also similar in most of their other demographic characteristics. Riverside There about as many white non-Hispanics as Latinos among both the enrollee and opt-out populations in San Diego County, with each group accounting for slightly more than a third of the total. Los Angeles 5. Demographic characteristics of CMC enrollees and opt-outs in San Diego County Overall San Diego County 92
Overall San Diego County Table SD-5 46% Female 54% 37% 65 -74 35% 28% 36% Latino 38% 32% 30% 36% 39% 9% 8% Asian American 9% 8% Other/not reported 8% 9% Orange African American San Mateo Race/ethnicity White non-Hispanic 38% Santa Clara 75 or older 57% San Diego Age Under 65 43% San Bernardino Gender Male CMC opt-outs Riverside CMC enrollees Los Angeles Comparing the demographic characteristics of CMC enrollees and CMC opt-outs (1) 93
Overall San Diego County Table SD-5 CMC opt-outs Not a high school graduate 36% 37% 23% Some college/trade school 23% 65% 26% 63% San Mateo Receive Supplemental Security Assistance benefits Yes No 16% 15% Santa Clara College graduate San Diego High school graduate San Bernardino Education Riverside CMC enrollees Los Angeles Comparing the demographic characteristics of CMC enrollees and CMC opt-outs (2) 26% Orange Note: Differences between 100% and the sum of percentages for each characteristic equal proportion not reporting an answer. 94
San Diego Santa Clara However, a slightly larger proportion of opt-outs (51%) than enrollees (44%) say they use specialized equipment, such as a cane, wheelchair, scooter or special bed, and opt-outs (47%) are also more likely than enrollees (37%) to report requiring assistance for common daily activities. San Bernardino About half of CMC enrollees (49%) and opt-outs (52%) report being in fair or poor physical health. These differences are not statistically significant. Riverside A smaller proportion of CMC enrollees (24%) than opt-outs (33%) in San Diego County report having been an overnight patient in a hospital in the past 12 months. Los Angeles 6. Health-related characteristics of CMC enrollees and opt-outs in San Diego County Overall San Diego County San Mateo Orange 95
Overall San Diego County Table SD-6 49% 44% Santa Clara Require assistance for common daily activities 37% 47% San Mateo 24% 33% Orange Overnight patient in a hospital past 12 months 51% San Diego Use specialized equipment, such as a cane, wheelchair, scooter or special bed 52% San Bernardino In fair or poor health CMC opt-outs Riverside CMC enrollees Los Angeles Comparing the health characteristics of CMC enrollees and CMC opt-outs 96
Overall Los Angeles Riverside San Bernardino San Diego Santa Clara County: Aggregated Results from Waves 1 -4 San Mateo Orange Field Research Corporation 97
San Bernardino San Diego Santa Clara There are no differences between enrollees and opt-outs in the County with regarding to knowing who to call if they have a health need or question. Riverside While large majorities of CMC enrollees and opt-outs in Santa Clara County express confidence that they know how to manage their health conditions and can get questions about their health needs answered, enrollees express somewhat lower levels of confidence than opt-outs. For example, while 79% of enrollees say they are confident that can perform each of these two tasks, among opt-outs 87% and 88%, respectively, report this. Los Angeles 1. CMC enrollee confidence in managing their health conditions in Santa Clara County Overall Santa Clara County San Mateo Orange 98
Overall Santa Clara County Table SC-1 CMC opt-outs Can get questions about your health needs answered (% confident) 79% 88% Know who to call if you have a health need or question (% yes) 79% Santa Clara 87% San Diego 79% San Bernardino Know how to manage your health conditions (% confident) Riverside CMC enrollees Los Angeles Confidence that beneficiaries know how to manage their health conditions, can get their questions answered, and know who to call San Mateo Orange 99
San Diego Santa Clara § The information their health plan gives explaining their benefits (72% vs. 80%) San Bernardino § The amount of time their doctor or other staff spend with them (83% among enrollees and 88% among opt-outs) Riverside While large majorities of CMC enrollees in Santa Clara County (between 72% and 83%) say they are satisfied with the health care services they are receiving in each of seven areas measured, slightly fewer enrollees than opt-outs report being satisfied in five areas. These include: Los Angeles 2. CMC enrollee satisfaction with their health services in Santa Clara County Overall Santa Clara County § Choice of doctors (79% vs. 88%) § The way different providers work together (78% vs. 84%) San Mateo § Choice of hospitals (79% vs. 89%) Orange 100
Overall Santa Clara County Table SC-2 72% 88% 80% San Diego Information health plan gives explaining your benefits (% satisfied) 83% San Bernardino Amount of time doctor/ other staff spend with you (% satisfied) CMC opt-outs Riverside CMC enrollees Los Angeles Satisfaction with different aspects of the health care services beneficiaries are receiving (1) Santa Clara 79% 88% Your choice of hospitals (% satisfied) 79% 88% San Mateo Your choice of doctors (% satisfied) Orange 101
Overall Santa Clara County Table SC-2 75% 80% 75% 77% Santa Clara San Mateo Your ability to call a health provider regardless of the time of day* (% satisfied) 84% San Diego How long you have to wait to see a doctor when you need an appointment (% satisfied) 78% San Bernardino The way different providers work together (% satisfied) CMC opt-outs Riverside CMC enrollees Los Angeles Satisfaction with different aspects of the health care services beneficiaries are receiving (2) Orange * Asked only in Waves 3 and 4. 102
Riverside San Bernardino San Diego Santa Clara Relatively small proportions of enrollees and opt-outs in Santa Clara County say they encountered any of six specific problems relating to their health services in the recent past. About one in five CMC enrollees say that a doctor they were seeing is not available through their plan or that they had a misunderstanding about their health care services or coverage. While similar proportions of optouts also cite these two problems, another one in five say they were denied a treatment or referral for another service recommended by a doctor or that transportation problems kept them from getting need health care. Los Angeles 3. Specific problems encountered by CMC enrollees with their health services in Santa Clara County Overall Santa Clara County San Mateo Orange 103
Overall Santa Clara County Table SC-3 CMC opt-outs 19% Had a misunderstanding about your health care services or coverage 21% 22% San Diego 20% 17% 22% Transportation problems kept you from getting needed health care 16% 21% 17%* Orange * Small sample base. 14% 12% San Mateo (among non- English speakers) 12% Santa Clara Was denied a treatment or referral for another service recommended by a doctor Had trouble communicating with a health provider because of a speech, hearing or other disability Health provider did not speak your language and no interpreter was available San Bernardino A doctor you were seeing is not available through your plan Riverside CMC enrollees Los Angeles Specific problems encountered with health services in the past year 104
Riverside San Bernardino Majorities of opt-outs in Santa Clara County cite three main reasons for choosing not to participate in Cal Medi. Connect. These include being satisfied with their current health care services/didn't want to make a change (86%), didn't want to risk losing their doctor (72%) or didn't want to risk losing their medicines (60%). No other problems are cited by more than 38%. Los Angeles 4. Reasons CMC opt-outs give for choosing not to participate in Cal Medi. Connect in Santa Clara County Overall Santa Clara County San Diego Santa Clara San Mateo Orange 105
Overall Santa Clara County Table SC-4 Los Angeles Reasons CMC opt-outs give for choosing not to participate in Cal Medi. Connect Riverside CMC opt-outs 86% Didn’t want to risk losing my doctor 72% San Diego Didn’t want to risk losing any of my medicines* 60% Thought my benefits and services might be reduced 37% Orange * Asked only in Waves 3 and 4. 18% San Mateo 38% Santa Clara Didn’t understand the information I received about the new program enough to make the change My doctor/other health provider recommended that I not participate San Bernardino Satisfied with my current health care services/didn’t want to make a change 106
Orange § About six in ten of CMC enrollees and opt-outs say they receive Supplemental Security Income assistance from the federal government. San Mateo § About three in ten of each group are under age 65, while greater than four in ten are age 75 or older. Santa Clara § A majority of both enrollees (57%) and opt-outs (60%) are women. San Diego The enrollee and opt-out populations in Santa Clara County are similar on most of their other demographic characteristics. For example: San Bernardino About one in three of the CMC enrollees (34%) and 29% of opt-outs in Santa Clara County have not graduated from high school. At the other end of the scale, college graduates account for 23% of the county’s enrollees, and 20% of its opt-outs. Riverside A relatively large proportion of the CMC enrollees in Santa Clara County are Asian American (30%), and Asian Americans comprise an even greater share of the county’s opt-outs (37%). Latinos account for the next largest share of both enrollees and opt-outs, followed by white non-Hispanics. Los Angeles 5. Demographic characteristics of CMC enrollees and opt-outs in Santa Clara County Overall Santa Clara County 107
Overall Santa Clara County Table SC-5 43% Female 57% 38% 65 -74 30% 32% 4% 29% 3% 30% 7% 23% 37% 8% Orange Asian American 42% San Mateo 27% Latino Other/not reported 28% 42% Race/ethnicity White non-Hispanic 30% Santa Clara 75 or older 60% San Diego Age Under 65 African American 40% San Bernardino Gender Male CMC opt-outs Riverside CMC enrollees Los Angeles Comparing the demographic characteristics of CMC enrollees and CMC opt-outs (1) 108
Overall Santa Clara County Table SC-5 CMC opt-outs Not a high school graduate 29% 34% 21% 23% Some college/trade school 20% 23% 61% 30% 61% San Mateo Receive Supplemental Security Assistance benefits Yes No 20% 23% Santa Clara College graduate San Diego High school graduate San Bernardino Education Riverside CMC enrollees Los Angeles Comparing the demographic characteristics of CMC enrollees and CMC opt-outs (2) 26% Orange Note: Differences between 100% and the sum of percentages for each characteristic equal proportion not reporting an answer. 109
San Bernardino San Diego There are no significant differences between enrollees and opt-outs on three other health-related measures – using specialized equipment, such as a cane, wheelchair, scooter or special bed, requiring assistance to perform common daily activities and being an overnight patient in a hospital in the past 12 months. Riverside Slightly fewer enrollees (42%) than opt-outs (49%) in Santa Clara County report being in fair or poor physical health. Los Angeles 6. Health-related characteristics of CMC enrollees and opt-outs in Santa Clara County Overall Santa Clara County Santa Clara San Mateo Orange 110
Overall Santa Clara County Table SC-6 CMC opt-outs 49% Use specialized equipment, such as a cane, wheelchair, scooter or special bed 43% 45% Santa Clara Require assistance for common daily activities 37% 38% San Mateo 23% 20% Orange Overnight patient in a hospital past 12 months San Diego 42% San Bernardino In fair or poor health Riverside CMC enrollees Los Angeles Comparing the health characteristics of CMC enrollees and CMC opt-outs 111
Overall Los Angeles Riverside San Bernardino San Diego Santa Clara San Mateo County: Aggregated Results from Waves 3 and 4 San Mateo Orange Field Research Corporation 112
Riverside San Bernardino San Diego Both CMC enrollees and opt-outs in San Mateo County express similar high levels of confidence that they know how to manage their health conditions and can get questions about their health needs answered. In each area, greater than eight in ten say they are confident that they can perform each task. There also no significant differences between enrollees and opt-outs in the county with regard to knowing who to call if they have a health need or question. Los Angeles 1. CMC enrollee confidence in managing their health conditions in San Mateo County Overall San Mateo County Santa Clara San Mateo Orange 113
Overall San Mateo County Table SM-1 82% 79% 82% Know who to call if you have a health need or question (% yes) 85% 87% Santa Clara 85% San Diego Can get questions about your health needs answered (% confident) San Bernardino Know how to manage your health conditions (% confident) CMC opt-outs Riverside CMC enrollees Los Angeles Confidence that beneficiaries know how to manage their health conditions, can get their questions answered, and know who to call San Mateo Orange 114
Riverside San Bernardino While large majorities of CMC enrollees in San Mateo County (between 74% and 88%) say they are satisfied with the services they are receiving in each of seven areas, on each measure even larger proportions of CMC opt-outs report being satisfied. Los Angeles 2. CMC enrollee satisfaction with their health services in San Mateo County Overall San Mateo County San Diego Santa Clara San Mateo Orange 115
Overall San Mateo County Table SM-2 88% 95% 94% Your choice of doctors (% satisfied) 83% 98% Your choice of hospitals (% satisfied) 83% 91% Santa Clara 81% San Diego Information health plan gives explaining your benefits (% satisfied) San Bernardino Amount of time doctor/ other staff spend with you (% satisfied) CMC opt-outs Riverside CMC enrollees Los Angeles Satisfaction with different aspects of the health care services beneficiaries are receiving (1) San Mateo Orange 116
Overall San Mateo County Table SM-2 CMC opt-outs How long you have to wait to see a doctor when you need an appointment (% satisfied) 82% 94% 74% 93% San Mateo Your ability to call a health provider regardless of the time of day* (% satisfied) Santa Clara 92% San Diego 84% San Bernardino The way different providers work together (% satisfied) Riverside CMC enrollees Los Angeles Satisfaction with different aspects of the health care services beneficiaries are receiving (2) Orange * Asked only in Waves 3 and 4. 117
Riverside San Bernardino San Diego Fewer than one in five enrollees say they encountered any of six specific problems relating to their health services in the recent past. Most commonly reported was having a misunderstanding about their health care services or coverage (19%). Among opt-outs, about one in four (26%) reports that a transportation problem kept them from getting need health care, more than twice the proportion of enrollees (11%) reporting this. Los Angeles 3. Specific problems encountered by CMC enrollees with their health services in San Mateo County Overall San Mateo County Santa Clara San Mateo Orange 118
Overall San Mateo County Table SM-3 Was denied a treatment or referral for another service recommended by a doctor N/A: Not available due to very small sample base. 8% 11% 26% 10% 2% 12% N/A Orange (among non- English speakers) 14% San Mateo Had trouble communicating with a health provider because of a speech, hearing or other disability Health provider did not speak your language and no interpreter was available 10% Santa Clara Transportation problems kept you from getting needed health care 19% 9% San Diego Had a misunderstanding about your health care services or coverage 13% San Bernardino A doctor you were seeing is not available through your plan CMC opt-outs Riverside CMC enrollees Los Angeles Specific problems encountered with health services in the past year 119
Riverside San Bernardino San Diego Majorities of opt-outs in San Mateo County cite three main reasons for choosing not to participate in Cal Medi. Connect. These include being satisfied with their current health care services/didn't want to make a change (88%), didn't want to risk losing any of their medicines (63%), and didn't want to risk losing a doctor (61%). Two other reasons are cited by about four in ten – thought their benefits might be reduced (44%), and didn't understand the information they received about the new program (42%). Los Angeles 4. Reasons CMC opt-outs give for choosing not to participate in Cal Medi. Connect in San Mateo County Overall San Mateo County Santa Clara San Mateo Orange 120
Overall San Mateo County Table SM-4 Los Angeles Reasons CMC opt-outs give for choosing not to participate in Cal Medi. Connect Riverside CMC opt-outs 88% 61% Didn’t want to risk losing any of my medicines* 63% San Diego Didn’t want to risk losing my doctor Thought my benefits and services might be reduced 44% Orange * Asked only in Waves 3 and 4. 4% San Mateo 42% Santa Clara Didn’t understand the information I received about the new program enough to make the change My doctor/other health provider recommended that I not participate San Bernardino Satisfied with my current health care services/didn’t want to make a change 121
San Mateo Orange Majorities of both enrollees (59%) and opt-outs (66%) say they are receiving Supplemental Security Income assistance from the federal government. Santa Clara Fewer than half of CMC enrollees in the county (47%) have no more than a high school education. This compares to 57% among opt-outs. San Diego The age distributions of enrollees and opt-outs in the county are also similar, with about three in ten under age 65, a similar proportion age 65 -74 and about four in ten age 75 or older. San Bernardino About six in ten of both enrollees (62%%) and opt-outs (59%) are women. Riverside White non-Hispanics account for a larger share of San Mateo County's CMC enrollees (33%) than are found among its opt-outs (19%). By contrast, Latinos comprise a far larger share of the county's opt-outs (49%) than they do of its enrollees (29%). Significant proportions of the enrollees (26%) and opt-outs (19%) in the county are Asian American. Los Angeles 5. Demographic characteristics of CMC enrollees and opt-outs in San Mateo County Overall San Mateo County 122
Overall San Mateo County Table SM-5 38% Female 62% 27% 65 -74 Latino 29% 9% 49% 10% 26% 3% 19% 3% Orange Asian American 37% San Mateo 33% 31% Santa Clara 42% Race/ethnicity White non-Hispanic Other/not reported 32% 31% 75 or older 59% San Diego Age Under 65 African American 41% San Bernardino Gender Male CMC opt-outs Riverside CMC enrollees Los Angeles Comparing the demographic characteristics of CMC enrollees and CMC opt-outs (1) 123
Overall San Mateo County Table SM-5 CMC opt-outs Not a high school graduate 26% 19% 26% 27% College graduate 26% 14% No 59% 31% 66% San Mateo Receive Supplemental Security Assistance benefits Yes Santa Clara Some college/trade school San Diego High school graduate 31% 28% San Bernardino Education Riverside CMC enrollees Los Angeles Comparing the demographic characteristics of CMC enrollees and CMC opt-outs (2) 30% Orange Note: Differences between 100% and the sum of percentages for each characteristic equal proportion not reporting an answer. 124
San Bernardino San Diego However, there are no significant differences between the enrollee and opt-out populations with regard to their using specialized equipment, requiring assistance to perform common daily activities, or being an overnight patient in a hospital in the past 12 months. Riverside Fewer than half of enrollees in San Mateo County (45%) report being in fair or poor physical health. By contrast, a 57% majority of opt-outs report this. Los Angeles 6. Health-related characteristics of CMC enrollees and opt-outs in San Mateo County Overall San Mateo County Santa Clara San Mateo Orange 125
Overall San Mateo County Table SM-6 45% 39% 41% San Mateo 28% 24% Orange Overnight patient in a hospital past 12 months 41% Santa Clara Require assistance for common daily activities 50% San Diego Use specialized equipment, such as a cane, wheelchair, scooter or special bed 57% San Bernardino In fair or poor health CMC opt-outs Riverside CMC enrollees Los Angeles Comparing the health characteristics of CMC enrollees and CMC opt-outs 126
Overall Los Angeles Riverside San Bernardino San Diego Santa Clara Orange County: Aggregated Results from Waves 3 and 4 San Mateo Orange Field Research Corporation 127
Riverside San Bernardino San Diego Nearly eight in CMC enrollees in Orange County express confidence that they know how to manage their health conditions, can get questions about their health needs answered and know who to call if they have a health need or question. Opt-outs express significantly higher levels of confidence than enrollees in two areas – knowing how to manage their health conditions and knowing who to call when they have a health need or question. Los Angeles 1. CMC enrollee confidence in managing their health conditions in Orange County Overall Orange County Santa Clara San Mateo Orange 128
Overall Orange County Table OR-1 CMC opt-outs Can get questions about your health needs answered (% confident) 78% 83% Know who to call if you have a health need or question (% yes) 79% 90% Santa Clara 87% San Diego 77% San Bernardino Know how to manage your health conditions (% confident) Riverside CMC enrollees Los Angeles Confidence that beneficiaries know how to manage their health conditions, can get their questions answered, and know who to call San Mateo Orange 129
Santa Clara § Ability to call a health provider regardless of the time of day (72% vs. 81%) San Diego § The way different providers work together (81% vs. 89%) San Bernardino § Choice of hospitals (73% among enrollees vs. 84% among opt-outs) Riverside Large majorities of CMC enrollees in Orange County (between 72% and 82%) are satisfied with the health services they are receiving across the seven areas measured. However, even larger proportions of opt-outs in the county report being satisfied in three areas. These include: Los Angeles 2. CMC enrollee satisfaction with their health services in Orange County Overall Orange County San Mateo Orange 130
Overall Orange County Table OR-2 CMC opt-outs Information health plan gives explaining your benefits (% satisfied) 81% Your choice of doctors (% satisfied) 81% 86% San Mateo 73% 84% Orange Your choice of hospitals (% satisfied) Santa Clara 84% San Diego 82% San Bernardino Amount of time doctor/ other staff spend with you (% satisfied) Riverside CMC enrollees Los Angeles Satisfaction with different aspects of the health care services beneficiaries are receiving (1) 131
Overall Orange County Table OR-2 80% Santa Clara 72% 81% San Mateo Your ability to call a health provider regardless of the time of day* (% satisfied) 78% 89% San Diego How long you have to wait to see a doctor when you need an appointment (% satisfied) 81% San Bernardino The way different providers work together (% satisfied) CMC opt-outs Riverside CMC enrollees Los Angeles Satisfaction with different aspects of the health care services beneficiaries are receiving (2) Orange * Asked only in Waves 3 and 4. 132
San Bernardino San Diego Santa Clara Among opt-outs 21% report having a misunderstanding about their health care services or coverage, while 19% each report that a doctor they were seeing was not available through their plan or that they were denied a treatment or referral for another service recommended by a doctor. Another 16% also report that transportation problems kept them from getting needed care. Riverside Relatively small proportions of CMC enrollees and opt-outs in Orange County say they encountered any of six specific problems with their health services in the recent past. Most commonly reported among enrollees are that a doctor they were seeing was no longer available through their plan (20%) or that they had a misunderstanding about their health care services or coverage (17%). Los Angeles 3. Specific problems encountered by CMC enrollees with their health services in Orange County Overall Orange County San Mateo Orange 133
Overall Orange County Table OR-3 20% Had a misunderstanding about your health care services or coverage 17% 13% 5% 16% 9% N/A Orange N/A: Not available due to very small sample base. 11% 19% San Mateo (among non- English speakers) 13% Santa Clara Had trouble communicating with a health provider because of a speech, hearing or other disability Health provider did not speak your language and no interpreter was available 21% San Diego Was denied a treatment or referral for another service recommended by a doctor Transportation problems kept you from getting needed health care 19% San Bernardino A doctor you were seeing is not available through your plan CMC opt-outs Riverside CMC enrollees Los Angeles Specific problems encountered with health services in the past year 134
Riverside San Bernardino San Diego Most opt-outs in Orange County cite two main reasons for choosing not to participate in Cal Medi. Connect. These include being satisfied with their current health care services/didn't want to make a change (93%) or didn't want to risk losing a doctor (71%). Another 58% say they didn't want to risk losing their medicines, while 45% thought their benefits might be reduced and 39% say they didn't understand the information they received about the new program. Los Angeles 4. Reasons CMC opt-outs give for choosing not to participate in Cal Medi. Connect in Orange County Overall Orange County Santa Clara San Mateo Orange 135
Overall Orange County Table OR-4 Los Angeles Reasons CMC opt-outs give for choosing not to participate in Cal Medi. Connect Riverside CMC opt-outs 93% Didn’t want to risk losing my doctor 71% San Diego Didn’t want to risk losing any of my medicines* 58% 39% 13% Orange * Asked only in Waves 3 and 4. 45% San Mateo Thought my benefits and services might be reduced Santa Clara Didn’t understand the information I received about the new program enough to make the change My doctor/other health provider recommended that I not participate San Bernardino Satisfied with my current health care services/didn’t want to make a change 136
San Mateo Orange Slightly fewer enrollees (55%) than opt-outs (65%) in the county say they are receiving Supplemental Security Income assistance from the federal government. Santa Clara Slightly less than four in ten CMC enrollees (36%) in Orange County have not graduated from high school, while among opt-outs 44% say this. At the other end of the scale, 17% of enrollees and 22% of opt-outs in the county are college graduates. San Diego Beneficiaries, both enrollees and opt-outs, skew older in Orange County. Only about one in five enrollees (21%) and opt-outs (23%) are under age 65, while nearly half are age 75 or older. San Bernardino Women comprise a somewhat smaller share of enrollees in the county (56%) than among opt-outs (65%). Riverside About half of CMC enrollees (45%) and opt-outs (50%) in Orange County are Latino. However, significantly more enrollees (36%) than opt-outs (23%) are white non-Hispanic. Los Angeles 5. Demographic characteristics of CMC enrollees and opt-outs in Orange County Overall Orange County 137
Overall Orange County Table OR-5 44% Female 56% 21% 65 -74 23% 30% 32% 49% Latino 45% 2% Other/not reported 4% 14% 3% 50% 16% 7% Orange Asian American 23% San Mateo 36% 45% Santa Clara 75 or older Race/ethnicity White non-Hispanic 65% San Diego Age Under 65 African American 35% San Bernardino Gender Male CMC opt-outs Riverside CMC enrollees Los Angeles Comparing the demographic characteristics of CMC enrollees and CMC opt-outs (1) 138
Overall Orange County Table OR-5 CMC opt-outs Not a high school graduate Some college/trade school 22% 17% 55% 30% 65% San Mateo Receive Supplemental Security Assistance benefits Yes No 17% 21% Santa Clara College graduate 16% 17% San Diego High school graduate 44% 36% San Bernardino Education Riverside CMC enrollees Los Angeles Comparing the demographic characteristics of CMC enrollees and CMC opt-outs (2) 29% Orange Note: Differences between 100% and the sum of percentages for each characteristic equal proportion not reporting an answer. 139
San Diego Santa Clara San Mateo However, a slightly larger proportion of enrollees (45%) than opt-outs (32%) say they use specialized equipment, such as a cane, wheelchair, scooter or special bed. San Bernardino There also no significant differences between the enrollee and opt-out populations who report requiring assistance to perform common daily activities. Riverside Significantly fewer enrollees (21%) than opt-outs (34%) in Orange County report having been an overnight patient in the hospital in the past year. This is noteworthy, especially since similar proportions of both enrollees and opt-outs in Orange County (37%) report being in fair or poor physical health. Los Angeles 6. Health-related characteristics of CMC enrollees and opt-outs in Orange County Overall Orange County Orange 140
Overall Orange County Table OR-6 37% 32% 36% San Mateo 21% 34% Orange Overnight patient in a hospital past 12 months 32% Santa Clara Require assistance for common daily activities 45% San Diego Use specialized equipment, such as a cane, wheelchair, scooter or special bed 37% San Bernardino In fair or poor health CMC opt-outs Riverside CMC enrollees Los Angeles Comparing the health characteristics of CMC enrollees and CMC opt-outs 141
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