Inicio Proveedores y socios Iniciativa de Atención Coordinada y Cal MediConnect

Iniciativa de Atención Coordinada y Cal MediConnect

Regreso a la Atención Integrada para Beneficiarios con Doble Elegibilidad

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Passage of the Coordinated Care Initiative (CCI) in July 2012 marked an important step toward transforming California’s Medi-Cal (Medicaid) care delivery system to better serve the state’s low-income seniors and persons with disabilities. Building upon many years of stakeholder discussions, the CCI begins the process of integrating delivery of medical, behavioral, and long-term care services and provides a road map to integrate Medicare and Medi-Cal for beneficiaries of both programs, called “dual eligible” beneficiaries.  

Created through a public process involving stakeholders and health care consumers, the CCI was enacted through Senate Bill 1008 (Chapter 33, Statutes of 2012) and Senate Bill 1036 (Chapter 45, Statutes of 2012).

The CCI was implemented in seven counties beginning in 2014. The seven counties are Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara.

Partes principales de la Iniciativa de Atención Coordinada

  • Cal MediConnect: Un Plan de salud voluntario para que los beneficiarios con doble elegibilidad reciban servicios médicos coordinados, de salud conductual, institucionales a largo plazo y basados en el hogar y la comunidad a través de un solo sistema de prestación organizado. Cal MediConnect combina los beneficios de Medicare y Medi-Cal con beneficios adicionales de coordinación de la atención.  
  • Apoyos y Servicios Administrados Medi-Cal a Largo Plazo (MLTSS, por sus siglas en inglés): Todos los Medi-Cal beneficiarios, incluidos los beneficiarios con doble elegibilidad, en los condados de CCI deben inscribirse en un Plan de salud Medi-Cal Managed Care para recibir sus beneficios Medi-Cal , incluidos los beneficios LTSS y Medicare integrales.

What’s New with Cal MediConnect

Under the California Advancing and Innovating Medi-Cal (CalAIM) initiative, starting on January 1, 2023, Cal MediConnect members will be transitioned to MMPs, or Medi-Medi Plans. MMPs is the California-specific program name for Exclusively Aligned Enrollment Dual Eligible Special Needs Plans (EAE D-SNPs). Under exclusively aligned enrollment, beneficiaries can enroll in a D-SNP for Medicare benefits and in a Medi-Cal managed care plan for Medi-Cal benefits, which are both operated by the same parent organization for better care coordination and integration. DHCS will work with health plans, stakeholders, and the Centers for Medicare & Medicaid Services (CMS) to transition and expand integrated care statewide.  This policy is intended to help meet the statewide goals of improved care integration and person-centered care, under both the CalAIM initiative and the California Master Plan for Aging.

DHCS is convening the monthly public CalAIM MLTSS & Duals Integration Workgroup to work with stakeholders to support this transition. Information on how to register for the CalAIM MLTSS & Duals Integration Stakeholder Workgroup, and background materials from previous workgroup meetings is available here.

Información general

  • How to Enroll – Shares basic information about how to enroll in Cal MediConnect.
  • Cal MediConnect Benefits and Services – Includes basic information about CMC’s benefits/services.
  • PACE – Includes brief background on the PACE program, a link to CalPACE, and four PACE FAQs.
  • Health Plan 101 – An explanation of different health plan components and a series of related questions and answers.

Hojas informativas de CCI

  1. Recursos para los beneficiarios

     2. Recursos para proveedores

     3. Recursos para Defensores

     4. Información histórica de CCI

Legislación adoptada

Versiones anteriores del texto legislativo

For more information about the Coordinated Care Initiative and Cal MediConnect, please visit the Integrated Care for Dual Eligible Beneficiaries webpage.