Coordinated Care Initiative thiab Cal MediConnect
Rov qab mus rau Kev Pabcuam Kev Sib Txuas rau Cov Neeg Tau Txais Kev Pabcuam Dual
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.
Tsim los ntawm cov txheej txheem pej xeem uas muaj cov neeg koom nrog thiab cov neeg siv khoom kho mob, CCI tau tsim los ntawm Senate Bill 1008 (Tshooj 33, Statutes ntawm 2012) thiab Senate Bill 1036 (Tshooj 45, Statutes ntawm 2012).
CCI tau siv rau hauv xya lub nroog pib xyoo 2014. Xya lub nroog yog Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, thiab Santa Clara.
Qhov Tseem Ceeb ntawm Txoj Kev Pabcuam Kev Sib Koom Tes
- Cal MediConnect: Ib txoj kev npaj khomob pub dawb rau cov neeg tau txais txiaj ntsig ob leeg tau txais kev sib koom tes kho mob, kev noj qab haus huv ntawm tus cwj pwm, kev ua haujlwm mus sij hawm ntev, thiab kev pabcuam hauv tsev thiab hauv zej zog los ntawm ib qho kev npaj xa tuaj. Cal MediConnect suav nrog Medicare thiab Medi-Cal cov txiaj ntsig nrog cov txiaj ntsig kev saib xyuas ntxiv.
- Tswj Medi-Cal Kev Pabcuam Sijhawm Ntev thiab Kev Pabcuam (MLTSS): Txhua tus neeg tau txais txiaj ntsig Medi-Cal, suav nrog ob tus neeg tau txais txiaj ntsig, hauv CCI cov nroog yuav tsum tau koom nrog Medi-Cal kev saib xyuas kev noj qab haus huv kom tau txais lawv cov txiaj ntsig Medi-Cal, suav nrog LTSS thiab Medicare muab cov txiaj ntsig zoo.
What’s New with Cal MediConnect
Raws li California Advancing and Innovating Medi-Cal (CalAIM) txoj kev pib, pib txij lub Ib Hlis 1, 2023, cov tswv cuab ntawm Cal MediConnect yuav raug hloov mus rau MMPs, lossis Medi-Medi Plans. MMPs yog lub npe ntawm cov kev pab cuam tshwj xeeb hauv California rau Exclusively Aligned Enrollment Dual Eligible Special Needs Plans (EAE D-SNPs). Nyob rau hauv kev sau npe sib phim tshwj xeeb, cov neeg tau txais txiaj ntsig tuaj yeem sau npe rau hauv D-SNP rau cov txiaj ntsig Medicare thiab hauv Medi-Cal txoj kev npaj kho mob rau cov txiaj ntsig Medi-Cal, uas ob qho tib si ua haujlwm los ntawm tib lub koom haum niam txiv rau kev sib koom tes zoo dua thiab kev koom ua ke. DHCS yuav ua haujlwm nrog cov phiaj xwm kev noj qab haus huv, cov neeg koom nrog, thiab Lub Chaw rau Medicare & Medicaid Services (CMS) los hloov pauv thiab nthuav dav kev saib xyuas sib koom ua ke thoob plaws lub xeev. Txoj cai no yog los pab ua kom tau raws li lub hom phiaj thoob plaws lub xeev ntawm kev txhim kho kev koom ua ke ntawm kev saib xyuas thiab kev saib xyuas tus neeg, raws li ob qho tib si CalAIM initiative thiab California Master Plan for Aging.
DHCS tab tom sib sau ua ke CalAIM MLTSS & Duals Integration Workgroup txhua hli los ua haujlwm nrog cov neeg koom tes los txhawb qhov kev hloov pauv no. Cov ntaub ntawv qhia txog yuav sau npe rau CalAIM MLTSS & Duals Integration Stakeholder Workgroup li cas, thiab cov ntaub ntawv keeb kwm yav dhau los ntawm cov rooj sib tham ua haujlwm yav dhau los muaj nyob ntawm no.
Cov ntaub ntawv dav dav
- Yuav Sau Npe Li Cas - Qhia cov ntaub ntawv yooj yim txog yuav sau npe rau hauv Cal MediConnect li cas.
- Cov Kev Pabcuam thiab Cov Kev Pabcuam ntawm Cal MediConnect - Muaj cov ntaub ntawv yooj yim txog cov txiaj ntsig/kev pabcuam ntawm CMC.
- 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.
CCI Fact Sheets
- Cov peev txheej rau cov neeg tau txais txiaj ntsig
- Cov Lus Nug Txog Tus Neeg Tau Txais Txiaj Ntsig - Muaj cov lus nug txog CMC rau cov neeg tau txais txiaj ntsig.
- Cov cuab yeej siv tau txais txiaj ntsig (English)
- Cov cuab yeej tau txais txiaj ntsig (Spanish)
- Cov Khoom Siv Kho Mob Ntev Ntev Cov Tswv Cuab Cov Ntaub Ntawv
- Xov Xwm Medi-Cal: Cov txiaj ntsim kev thauj mus los dawb!
- Koj Cov Kev Pab Kho Hniav Los ntawm Medi-Cal
2. Cov peev txheej rau cov neeg muab kev pab
- Cov cuab yeej kws kho mob
- Tsev Kho Mob Case Manager Toolkit
- CCI Tus Muab Kev Pab FAQ
- Daim Ntawv Qhia Txog Cov Khoom Siv Kho Mob Ntev
3. Cov peev txheej rau cov neeg tawm tswv yim
- Cov Kws Pab Tswv Yim rau CCI
- Ob Qhov Kev Tiv Thaiv Kev Tsim Nyog Cal MediConnect: Kev Txiav Txim thiab Kev Pab Them Nyiaj Them Tsis Taus
4. Cov ntaub ntawv keeb kwm CCI
- Keeb Kwm Txog CCI - Muaj cov ntaub ntawv luv luv txog CCI thiab tsib lo lus nug nquag nug txog CCI
- What is Cal MediConnect? – A brief overview of Cal MediConnect (CMC), including which benefits are coordinated and information about how to join.
- Managed Long-Term Services and Supports (MLTSS) page –Includes brief information about MLTSS, a link to find an MLTSS plan, and three MLTSS FAQs.
- CCI-HIV Fact Sheet (Lub Kaum Hli 2015)
- Coordinated Care Initiative: Executive Summary (Hloov Kho Lub Peb Hlis 27, 2013)
- CCI Population Chart: Updated table showing groups included in and excluded from the demonstration and mandatory Medi-Cal enrollment (March 27, 2013)
- Cov Lus Qhia Txog Cov Neeg Nyob Hauv CCI: (Lub Peb Hlis 27, 2013) Cov lus qhia txog cov neeg koom nrog
- CCI Beneficiary Protections: (August 30, 2012) A summary of all the beneficiary protections included in the CCI.
- CCI Legislative Reporting Requirements: (August 30, 2012) A summary of the legislative reporting requirements for the CCI.
- CCI Stakeholder Engagement Requirements ( Lub Yim Hli, 30, 2012) Cov ntsiab lus luv luv ntawm cov kev cai rov sib tham nrog cov neeg koom nrog.
- CCI Evaluation Strategy: (October 12, 2012) An overview of the evaluation and quality monitoring for the duals demonstration.
- CCI’s Commitment to Quality: (October 12, 2012) An overview of State efforts to advance high quality care delivery.
- Cal MediConnect Rate Reports
Txais Txoj Cai
- CCI Trailer Bill Senate Bill 1008 (Lub Xya Hli 2012)
- CCI Trailer Bill Senate Bill 1036 (July 2012)
Yav dhau los Versions ntawm Txoj Cai Lij Choj
- Cov Kev Hloov Kho Tshiab rau Cov Lus Qhia Txog Kev Pab Kho Mob ntawm Coordinated Care Initiative (Tsib Hlis 24, 2012
- Daim Ntawv Qhia Txog Kev Hloov Kho Tshiab rau CCI Trailer Bill Language thaum Lub Tsib Hlis (Tsib Hlis 24, 2012
- Kev Pabcuam Sijhawm Ntev thiab Kev Pabcuam TBL Daim Ntawv Qhia Tiav (Lub Peb Hlis 26, 2012
- Cov Lus Cai Lij Choj Txog Kev Koom Tes Saib Xyuas Kev Kho Mob ntawm Brown Administration (Lub Peb Hlis 26, 2012)
- Savings Estimates and Methodology for the Coordinated Care Initiative (February)
For more information about the Coordinated Care Initiative and Cal MediConnect, please visit the Integrated Care for Dual Eligible Beneficiaries webpage.