California Txoj Kev Hloov Kho Medi-Cal txuas ntxiv mus
XOV XWM TSHIAB
Kev Hloov Pauv Medi-Cal ntawm California Txuas Ntxiv Mus
Cov ntaub ntawv tshiab qhia ntau lub nroog tab tom ua kom zoo dua kev tswj hwm kev saib xyuas thiab kev txhawb nqa hauv zej zog, pab ntau tus neeg California tau txais kev saib xyuas lawv xav tau
SACRAMENTO — The Department of Health Care Services (DHCS) today released a quarterly update on the latest Enhanced Care Management (ECM) and Community Supports data. The data show an uptick in both the availability and use of Community Supports, showing significant growth in the number of counties offering these services.
ECM and Community Supports improve Medi-Cal members’ overall health and well-being by addressing both medical and social factors that can impact a person’s health, including housing assistance, medically tailored meals to support short-term recovery, homemakers, and personal services to create a high-touch, person-centered approach to care.
“Every day, more Medi-Cal members are benefitting from personalized care that goes beyond the traditional doctor’s office or hospital setting,” said DHCS Director Michelle Baass. “Enhanced Care Management and Community Supports are two key pillars of Medi-Cal transformation, and we’re seeing a great response. But there is still room to help even more people.”
“California Advancing and Innovating Medi-Cal (CalAIM) is a nation-leading effort that requires the support of all individuals, organizations, and health plans trusted with delivering care to members,” said State Medicaid Director Tyler Sadwith. “We are working closely with stakeholders, providers, and Medi-Cal managed care plans to ensure members and their caregivers know they can readily access these transformative services.”
WHAT THE DATA SHOW: As of January 2024, 23 counties offered all 14 Community Supports, and all counties offered at least seven Community Supports. This marks a significant increase from the end of 2022, when only three counties offered all 14 Community Supports. Overall, approximately 103,000 Californians (via Medi-Cal) used Community Supports in the first 21 months of the program, with more than 186,000 total services delivered. There is significant quarter-over-quarter growth in utilization; approximately 62,000 Californians (via Medi-Cal) utilized Community Supports in quarter (Q)3 2023 alone, up 170 percent from Q4 2022.
Tsis tas li ntawd xwb, tus naj npawb ntawm cov neeg California uas tau txais Medi-Cal los ntawm ECM txhua lub quarter tau nce ntxiv; hauv Q3 2023, kwv yees li 86,000 tus tswv cuab tau txais ECM, nce 28 feem pua ntawm Q4 2022. Tag nrho Q3 2023 suav nrog 6,300 tus tswv cuab hnub nyoog qis dua 21 xyoo, ntau tus ntawm lawv tau tsim nyog rau ECM thaum Lub Xya Hli 2023. Tag nrho, ntau dua 160,000 tus tswv cuab Medi-Cal thoob plaws lub xeev tau txais ECM hauv 21 lub hlis thawj zaug ntawm qhov txiaj ntsig.
WHY THIS MATTERS: This latest update shows a sustained increase in utilization as additional Populations of Focus (POF) become eligible for ECM and additional Community Supports services are offered in counties across the state.
DHCS expects to see more enrollment growth across ECM and Community Supports in the coming months and years. As California continues transforming Medi-Cal, ECM and Community Supports play a critical role in supporting whole-person care for Medi-Cal members with complex medical and health-related social needs. DHCS remains committed to supporting and sustaining this growth through program monitoring, design improvements, standardization, and direct technical assistance.
LAWV HAIS LI CAS:
- “At Pacific Clinics, everything we do helps the people we serve to achieve their wellness goals and advance health equity. Medi-Cal transformation is essential to this work,” said Vice President of Emerging and Statewide Services Jacquelyn H. Torres. “Through Community Supports, we provide crucial pathways to affordable housing for individuals and families. Additionally, Enhanced Care Management ensures access to comprehensive services tailored to meet complex health needs with life-affirming services and care.”
- “Enhanced Care Management represents a critical new safety net service in California,” said Leticia Galyean, CEO of Seneca Family of Agencies. Seneca is a nonprofit provider of behavioral health services to young people and their families, and currently holds 10 ECM contracts with managed care plans across the state. “Seneca is integrating Enhanced Care Management services with our full continuum of prevention and intensive services for young people, promoting true whole-person care and cross-system integration and collaboration in ways we could not before.”
TXOG COV KEV PAB CUAM THIAB COV KEV PAB CUAM NO: Cov nyiaj pab ECM muab kev tswj hwm kev saib xyuas uas tsom mus rau tus neeg rau cov tswv cuab Medi-Cal uas muaj kev xav tau kev kho mob thiab kev sib raug zoo nyuaj tshaj plaws. Cov tswv cuab uas tau txais ECM muaj ib tus thawj coj saib xyuas kev noj qab haus huv uas pab lawv sib koom tes saib xyuas kev noj qab haus huv thiab kev pabcuam hauv zej zog, ua rau nws yooj yim dua rau lawv kom tau txais kev saib xyuas zoo thaum lub sijhawm zoo hauv qhov chaw zoo - feem ntau yog qhov chaw uas lawv nyob. Kev Txhawb Nqa Hauv Zej Zog yog 14 qhov kev pabcuam uas muab los ntawm Medi-Cal cov phiaj xwm kev saib xyuas uas tswj hwm los pab cov tswv cuab daws lawv cov kev xav tau kev noj qab haus huv hauv zej zog, xws li kev nkag mus rau hauv tsev nyab xeeb lossis cov zaub mov noj qab haus huv kom pab lawv rov zoo los ntawm kev mob, zam kev kho mob siab dua thiab kim dua, thiab ua neej nyob zoo dua.
TAKING ACTION: DHCS and its managed care plan partners are working to expand access and use of ECM and Community Supports in 2024 and beyond by:
- Kev nthuav dav nkag mus rau ECM cov txiaj ntsig, nrog rau POFs ntxiv tsim nyog rau ECM pib txij Lub Ib Hlis 1, 2024, thiab nce cov kev pabcuam hauv zej zog muaj nyob hauv txhua lub nroog thoob plaws lub xeev.
- Txhim kho cov haujlwm thiab cov cai ntawm cov kev pab cuam kom tshem tawm cov teeb meem rau kev cog lus rau cov neeg muab kev pabcuam thiab kev siv cov kev pabcuam los ntawm ECM thiab Txoj Kev Npaj Txhawb Nqa Zej Zog uas suav nrog kev ua kom yooj yim rau kev tso cai thiab cov txheej txheem xa mus, nthuav dav cov tes hauj lwm ntawm cov neeg muab kev pabcuam, thiab txhim kho kev sib pauv cov ntaub ntawv.
- Providing grant funding and technical assistance to support providers in implementing and expanding capacity for ECM and Community Supports through Providing Access and Transforming Health (PATH), a $1.85 billion initiative.
- Kev tuav cov rooj sib tham tsis tu ncua, suav nrog PATH Collaborative Planning and Implementation (CPI) Cov pab pawg ua haujlwm rau cov neeg muab kev pabcuam thiab cov neeg zej zog thoob plaws lub xeev, txais tos cov lus pom zoo rau kev siv ECM thiab Kev Txhawb Zej Zog los ntawm ntau pawg neeg koom nrog rau cov neeg muab kev pabcuam thiab cov neeg zej zog thoob plaws lub xeev.
- Txhawb nqa cov phiaj xwm kev saib xyuas kev tswj hwm kom nce kev siv ECM thiab Kev Txhawb Zej Zog los ntawm Qhov Kev Pabcuam Nyiaj Txiag.
- Kev nthuav dav thiab siv ntau txoj hauv kev raws li qhov yuav tsum tau muaj hauv daim ntawv cog lus saib xyuas kev tswj hwm los txheeb xyuas cov tswv cuab uas yuav tau txais txiaj ntsig los ntawm ECM thiab Kev Txhawb Zej Zog. Qhov no tseem suav nrog kev ua kom muaj kev sib cog lus ntawm cov chaw muab kev pabcuam paub txog ECM cov txiaj ntsig thiab Cov Kev Pabcuam Hauv Zej Zog thiab cov kev tsim nyog tau txais dab tsi, thiab ua kom pom tseeb txoj hauv kev xa mus rau cov kev npaj saib xyuas.
- Ua kom muaj kev tswj xyuas cov phiaj xwm kev saib xyuas rau pej xeem cov vev xaib, cov tswv cuab hauv phau ntawv qhia, thiab cov chaw kho mob cov ntaub ntawv suav nrog cov ntaub ntawv tshiab tshaj plaws txog ECM thiab Cov Kev Txhawb Zej Zog muaj thiab yuav nkag mus rau lawv li cas.
BIGGER PICTURE: DHCS is transforming Medi-Cal to ensure Californians can get the care they need to live healthier lives. Medi-Cal members have access to new and improved services and receive comprehensive care that goes beyond the doctor’s office or hospital and addresses all of their physical and mental health needs. These changes will create a more coordinated, person-centered, and equitable health system that works for everyone, regardless of race, ethnicity, gender, sexual orientation, disability, immigration status, location, or health needs.
Medi-Cal yog tus thawj coj hauv lub tebchaws hauv kev muab cov neeg California nkag mus rau kev saib xyuas lawv xav tau los tsim kom muaj lub xeev muaj kev noj qab haus huv thiab sib luag.
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