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Findings from Waves 1-4 of the Rapid Cycle Polling Project

Overall. Los Angeles. Riverside. Findings from Waves 1-4 of the Rapid Cycle Polling Project. San Bernardino. San Diego. Santa Clara. conducted for The SCAN Foundation In conjunction with The California Department of Health Care Services

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Findings from Waves 1-4 of the Rapid Cycle Polling Project

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  1. Overall LosAngeles Riverside Findings from Waves 1-4 of the Rapid Cycle Polling Project San Bernardino SanDiego SantaClara conducted forThe SCAN Foundation In conjunction withThe California Departmentof Health Care Services byField Research Corporation,San Francisco, California November 2016 SanMateo Orange

  2. Overall Survey Objectives LosAngeles Riverside To evaluate and track over time the transitioning of beneficiaries to coordinated care under Cal MediConnect (CMC). By assessing the confidence and satisfaction of CMC enrollees with the health services they are receiving. 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. By understanding the factors associated with eligible beneficiaries choosing to opt out of CMC. San Bernardino SanDiego SantaClara SanMateo Orange

  3. Overall About the Surveys (1) LosAngeles Riverside Survey method • Telephone interviews with stratified random samples of dual eligible beneficiaries in Cal MediConnect (CMC) counties, as well as beneficiaries in two non-CMC counties for control purposes. Data collection periods • Wave 4 Survey: July – September 2016 • Wave 3 Survey: February – April 2016 • Wave 2 Survey: October – November 2015 • Wave 1 Survey: June – September 2015 Populations surveyed • 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) • Waves 3 and 4 were expanded to also include CMC enrollees and opt outs in two additional counties (San Mateo and Orange) San Bernardino SanDiego SantaClara SanMateo Orange

  4. Overall About the Surveys (2) LosAngeles Riverside Sample Sizes by Survey Wave • 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. Sample Sizes Waves 1 - 4(aggregated) • 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 Bernardino SanDiego SantaClara SanMateo Orange

  5. Overall LosAngeles Riverside San Bernardino Findings in Brief SanDiego SantaClara SanMateo Orange

  6. Overall Health care assessments of enrollees & opt-outs (1) LosAngeles Riverside Confidence in managing their health conditions • 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. • 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 SanDiego SantaClara SanMateo Orange

  7. Overall Health care assessments of enrollees & opt-outs (2) LosAngeles Riverside Satisfaction with the health care services they are receiving • 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. • 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 SanDiego SantaClara SanMateo Orange

  8. Overall Health care assessments of enrollees & opt-outs (3) LosAngeles Riverside Problems encountered with their health care • 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. • 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 SanDiego SantaClara SanMateo Orange

  9. Overall Reasons given by opt-outs for not participating in CMC LosAngeles Riverside The reasons given by opt-outs for choosing not to participate in Cal MediConnect in Wave 4 generally mirror those found in prior survey waves. • 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%). • 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%). • Relatively few (16%) report that their doctor or other health provider recommended that they not participate in the program. San Bernardino SanDiego SantaClara SanMateo Orange

  10. Overall Reported use of single care managers and personal health plans by enrollees & opt-outs LosAngeles 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. • The Wave 4 survey also finds no differences between enrollees and opt-outs 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. • 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. • A personal care plan was defined in the survey as a plan designed to take into account their health goals, needs and preferences. San Bernardino SanDiego SantaClara SanMateo Orange

  11. Overall Reported hospitalization of enrollees and opt-outs LosAngeles Riverside A somewhat smaller percentage of enrollees than opt-outs report having been an overnight patient in a hospital in the recent past. • 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. • 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. 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 Bernardino SanDiego SantaClara SanMateo Orange

  12. Overall Demographic characteristics of enrollees & opt-outs (1) LosAngeles 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 MediConnect (60%) than those who are enrolled in the program (54%). • 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%. • Among opt-outs, Orange County has the highest proportion of women at 65%, while San Diego County has the lowest at 57%. 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. Note: The findings in these section are based on the aggregated results of enrollees and opt-outs across all four waves of the survey. San Bernardino SanDiego SantaClara SanMateo Orange

  13. Overall Demographic characteristics of enrollees & opt-outs (2) LosAngeles Riverside There are relatively large variations in the ethnic composition of enrollees and opt-outs across the seven CMC counties. • Los Angeles County has the highest proportion of Latinos – 49% among enrollees and 44% among opt-outs. • Both Santa Clara and San Mateo counties have larger proportions of Asian American enrollees and opt-outs than do the other CMC counties. 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. • 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. San Bernardino SanDiego SantaClara SanMateo Orange

  14. Overall Demographic characteristics of enrollees & opt-outs (4) LosAngeles 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 opt-outs 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 opt-outs – are college graduates. • 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%). Greater than six in ten enrollees (62%) and opt-outs (63%) report receiving Supplemental Security Income assistance from the federal government. • There is relatively little variation about this by county, with majorities of enrollees and opt-outs in each county reportedly receiving such assistance. San Bernardino SanDiego SantaClara SanMateo Orange

  15. Overall LosAngeles Riverside San Bernardino Overall Findings Across the Four Survey Waves SanDiego SantaClara SanMateo Orange

  16. Overall 1. CMC enrollee confidence in managing their health conditions LosAngeles 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%). 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. There are no significant differences between the confidence levels expressed by CMC enrollee and CMC opt-outs on each measure. San Bernardino SanDiego SantaClara SanMateo Orange

  17. Overall Table 1 Confidence that beneficiaries know how to manage their health conditions, can get their questions answered, and know who to call LosAngeles Riverside San Bernardino SanDiego SantaClara SanMateo Orange

  18. Overall 2. CMC enrollee satisfaction with their health services LosAngeles 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. 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. 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 SanDiego SantaClara SanMateo Orange

  19. Overall Table 2 Satisfaction with different aspects of the health care services beneficiaries are receiving (1) LosAngeles Riverside San Bernardino SanDiego SantaClara SanMateo Orange

  20. Overall Table 2 Satisfaction with different aspects of the health care services beneficiaries are receiving (2) LosAngeles Riverside San Bernardino SanDiego SantaClara SanMateo Orange N/A: Question not asked in Waves 1 or 2.

  21. Overall 3. Specific problems encountered by CMC enrollees with their health services LosAngeles 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 MediConnect. 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%). The proportions citing each are similar to Wave 3, but tend to be lower than the proportions who reported these problems in earlier waves. 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 Bernardino SanDiego SantaClara SanMateo Orange

  22. Overall Table 3 Specific problems encountered with health services in the past year (1) LosAngeles Riverside San Bernardino SanDiego SantaClara SanMateo Orange

  23. Overall Table 3 Specific problems encountered with health services in the past year (2) LosAngeles Riverside San Bernardino SanDiego SantaClara SanMateo Orange * Small sample base.

  24. Overall 4. Reasons CMC opt-outs give for choosing not to participate in Cal MediConnect LosAngeles Riverside The reasons given by opt-outs in the Wave 4 survey for choosing not to participate in Cal MediConnect are very similar to what has been reported in prior survey waves. The three most frequently cited reasons continue to be: 86% Satisfied with my current health service/ didn't want to make a change 72% Didn't want to risk losing my doctor 63% Didn't want to risk losing any of my medicines In addition, slightly less than half of the opt-outs also report these two other reasons for not participating: 46% Didn't understand the information I received about the new program enough to make the change 44% Thought my benefits and services might be reduced San Bernardino SanDiego SantaClara SanMateo Orange

  25. Overall Table 4 Reasons CMC opt-outs give for choosing not to participate in Cal MediConnect LosAngeles Riverside San Bernardino SanDiego SantaClara SanMateo Orange N/A: Question not asked in Waves 1 or 2.

  26. Overall 5. Demographic characteristics of enrollees and opt-outs across the seven CMC counties (1) LosAngeles 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 MediConnect in the CMC counties. The following are the demographic characteristics of each population: • 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. San Bernardino SanDiego SantaClara SanMateo Orange

  27. Overall Table 5 Comparing the demographic characteristicsof enrollees and opt-outs in CMC counties (1) LosAngeles Riverside San Bernardino SanDiego SantaClara SanMateo Orange Note: Percentages shown are the combined totals for enrollees and opt-outs in CMC counties across all survey waves.

  28. Overall 5. Demographic characteristics of enrollees and opt-outs across the seven CMC counties (2) LosAngeles 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 opt-outs – are college graduates. • Nearly two-thirds of both enrollees (62%) and opt-outs (63%) report receiving Supplemental Security Income assistance benefits from the federal government. San Bernardino SanDiego SantaClara SanMateo Orange

  29. Overall Table 5 Comparing the demographic characteristicsof enrollees and opt-outs in CMC counties (2) LosAngeles Riverside San Bernardino SanDiego SantaClara SanMateo Orange Note: Differences between 100% and the sum of percentages for each characteristic equal proportion not reporting an answer.

  30. Overall 6. Health-related characteristics of enrollees and opt-outs across the seven CMC counties LosAngeles 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. 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. • Among opt-outs 45% include LTSS beneficiaries who require assistance for common daily activities. This compares to 40% among CMC enrollees. • More opt-outs (52%) than enrollees (48%) also report using specialized equipment, such as a cane, wheelchair, scooter or special bed. • 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. San Bernardino SanDiego SantaClara SanMateo Orange

  31. Overall Table 6 Comparing the health characteristics of enrollees and opt-outs in CMC counties LosAngeles Riverside San Bernardino SanDiego SantaClara SanMateo Orange Note: Percentages shown are the combined totals for enrollees and opt-outs in CMC counties across all survey waves.

  32. Overall 7. Length of time beneficiaries have been going to their personal doctor LosAngeles 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%). 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. San Bernardino SanDiego SantaClara SanMateo Orange

  33. Overall Table 7 Length of time beneficiaries have been going to the doctor they consider their personal doctor LosAngeles Riverside San Bernardino SanDiego SantaClara SanMateo Orange 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.

  34. Overall 8. Beneficiaries' experiences with single care managers* LosAngeles 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. 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.” San Bernardino SanDiego SantaClara SanMateo Orange * Single care manager described as “the person who serves as your main point of contact and arranges all aspects of your care.”

  35. Overall Table 8 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 LosAngeles Riverside CMC CMC Non-CMCenrolleesopt-outscounties W3W4W3W4W3W4 Has a single care manager 36%34%35%34%38%34% Has improved care… A lot 24 22 23 23 26 23 A little 6 7 7 6 7 7 Not at all 3 2 2 2 3 2 Not reported 3 3 3 2 2 2 San Bernardino SanDiego SantaClara SanMateo 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.

  36. Overall 9. Beneficiaries' experiences with a personal care plan* LosAngeles 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%). Across each segment about two-thirds of beneficiaries with personal care plans say that having such a plan has improved their care “a lot.” San Bernardino SanDiego SantaClara SanMateo Orange * Personal care plan described as a plan designed to take into account your health goals, needs and preferences.

  37. Overall Table 9 Beneficiaries who report having a personal care plan*and its perceived impact on the quality of their care LosAngeles Riverside CMC CMC Non-CMCenrolleesopt-outscounties W3W4W3W4W3W4 Has a personal care plan 33%36%38%38%40%42% Has improved care… A lot 22 23 26 28 26 27 A little 7 9 7 5 8 9 Not at all 3 2 3 3 3 3 Not reported 1 2 2 2 3 3 San Bernardino SanDiego SantaClara SanMateo 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.

  38. Overall LosAngeles Riverside San Bernardino Los Angeles County: Aggregated Results from Waves 1-4 SanDiego SantaClara SanMateo Orange

  39. Overall 1. CMC enrollee confidence in managing their health conditions in Los Angeles County LosAngeles Riverside 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. San Bernardino SanDiego SantaClara SanMateo Orange

  40. Overall Table LA-1 Confidence that beneficiaries know how to manage their health conditions, can get their questions answered, and know who to call LosAngeles Riverside San Bernardino SanDiego SantaClara SanMateo Orange

  41. Overall 2. CMC enrollee satisfaction with their health services in Los Angeles County LosAngeles 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: • Choice of doctors (81% among enrollees vs. 87% among opt-outs) • Choice of hospitals (78% vs. 83%) • The way different providers work together (80% vs. 83%) • How long you have to wait to see a doctor when you need an appointment (78% vs. 81%). San Bernardino SanDiego SantaClara SanMateo Orange

  42. Overall Table LA-2 Satisfaction with different aspects of the health care services beneficiaries are receiving (1) LosAngeles Riverside San Bernardino SanDiego SantaClara SanMateo Orange

  43. Overall Table LA-2 Satisfaction with different aspects of the health care services beneficiaries are receiving (2) LosAngeles Riverside San Bernardino SanDiego SantaClara SanMateo Orange * Asked only in Waves 3 and 4.

  44. Overall 3. Specific problems encountered by CMC enrollees with their health services in Los Angeles County LosAngeles 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. 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. San Bernardino SanDiego SantaClara SanMateo Orange

  45. Overall Table LA-3 Specific problems encountered with health services in the past year LosAngeles Riverside San Bernardino SanDiego SantaClara SanMateo Orange

  46. Overall 4. Reasons CMC opt-outs give for choosing not to participate in Cal MediConnect in Los Angeles County LosAngeles Riverside Majorities of opt-outs in Los Angeles County cite three main reasons for choosing not to participate in Cal MediConnect. 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%). San Bernardino SanDiego SantaClara SanMateo Orange

  47. Overall Table LA-4 Reasons CMC opt-outs give for choosing not to participate in Cal MediConnect LosAngeles Riverside San Bernardino SanDiego SantaClara SanMateo Orange * Asked only in Waves 3 and 4.

  48. Overall 5. Demographic characteristics of CMC enrollees and opt-outs in Los Angeles County LosAngeles 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%). 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%). Three in ten of both enrollees and opt-outs in Los Angeles County are under age 65, while 70% are age 65 or older. 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. 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. San Bernardino SanDiego SantaClara SanMateo Orange

  49. Overall Table LA-5 Comparing the demographic characteristicsof CMC enrollees and CMC opt-outs (1) LosAngeles Riverside San Bernardino SanDiego SantaClara SanMateo Orange

  50. Overall Table LA-5 Comparing the demographic characteristicsof CMC enrollees and CMC opt-outs (2) LosAngeles Riverside San Bernardino SanDiego SantaClara SanMateo Orange Note: Differences between 100% and the sum of percentages for each characteristic equal proportion not reporting an answer.

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