They are the “dual eligibles” — people who receive both Medicare and Medi-Cal benefits. Trying to coordinate care across two programs — one administered by the state under one set of rules, the other administered by the federal government under its own set of rules — can lead to highly fragmented care for this very costly population.

The goal is improved coordination of care and, ideally, improved health for this fragile population.

In a major shift triggered by the national healthcare law, nearly half a million low-income California seniors and disabled patients will begin moving into a new managed care program this fall. The patients, who receive both Medi-Cal and Medicare, are among the most costly in the state.

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Lisa Aliferis

Lisa Aliferis is the founding editor of KQED's State of Health blog. Since 2011, she's been writing stories and editing them for the site. Before taking up blogging, she toiled for many years producing health stories for television, including Dateline NBC and San Francisco's CBS affiliate, KPIX-TV. She also wrote up a handy guide to the Affordable Care Act, especially for Californians. You can follow her on Twitter: @laliferis

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