Coordinated Care Initiative thiab Cal MediConnect
Rov qab mus rau Integrated Care rau Dual Tsim Nyog tau txais txiaj ntsig
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.
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
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.
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- 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.
CCI Fact Sheets
- Cov peev txheej rau cov neeg tau txais txiaj ntsig
- Beneficiary FAQ – Includes basic FAQs about CMC for beneficiaries.
- 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
- Background on the CCI – Contains brief background information on the CCI and five FAQs about the 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)
- CCI Population Summary: (March 27, 2013) A summary of the participating populations
- 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 ntawm cov neeg koom nrog kev sib tham txog qhov yuav tsum tau ua.
- 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 Kho Kom Zoo Tshaj Plaws rau Txoj Kev Pabcuam Saib Xyuas Kev Pabcuam Trailer Bill Language (Tsib Hlis 24, 2012
- Daim Ntawv Qhia Qhov Tseeb Qhia Txog Lub Tsib Hlis Hloov Kho rau CCI Trailer Bill Language (Tsib 24, 2012
- Kev Pabcuam Sijhawm Ntev thiab Kev Pabcuam TBL Daim Ntawv Qhia Tiav (Lub Peb Hlis 26, 2012
- Legislative Language on the Brown Administration’s Coordinated Care Initiative (March 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.