California Home and Community-Based Services Gap Analysis and Multi-year Roadmap

Mathematica is conducting a statewide gap analysis of Medicaid-covered home and community-based services (HCBS) for the California Department of Health Care Services (DHCS). Under this project, the Mathematica team will employ a mixed-methods approach to identify critical gaps in California’s HCBS programs and service delivery system to meet the needs of beneficiaries. We will use quantitative methods to produce a comprehensive profile of current beneficiaries and providers of HCBS and the services they use and provide. We are developing a model to estimate demand for HCBS over the next five years, using demographic data, trends in service use by region, and caregiving patterns. We will employ qualitative methods, including key informant interviews, focus groups, and listening sessions to gather feedback from a diverse set of interested parties about the challenges with accessing and providing HCBS in California and to identify strategies to improve HCBS access and quality. The gap analysis will inform the development of a Multiyear Roadmap which will guide California's transformation to fully integrated managed long-term services and supports.

To expand the impact of the Medi-Cal gap analysis, the California Department of Aging (CDA) partnered with Mathematica to expand the analysis to non-Medi-Cal-covered HCBS. Under this project, the Mathematica team with expand this effort and include an accompanying program inventory and analysis of service use and demand for non-Medi-Cal HCBS programs and services. 

Our mixed-methods approach to analyze access to both Medi-Cal and non-Medi-Cal HCBS will ensure the recommendations Mathematica generates for CDA are informed by data, grounded in the realities of California’s diverse population, their needs, and the regions in which they live, and supported by key partners.