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Tsev Cov Chaw Muab Kev Pabcuam & Cov Neeg Koom Tes Pawg Neeg Ua Haujlwm Txog Kev Tswj Xyuas Kev Noj Qab Haus Huv ntawm Cov Neeg​​ 

Population Health Management Strategy Workgroup​​ 

Population Health Management Strategy​​ 

The population health management strategy component of California Advancing and Innovating Medi-Cal (CalAIM) addresses the initiative’s objectives of managing member risk and need and improving quality and health outcomes. DHCS currently does not have a requirement that Medi-Cal managed care plans maintain a population health management strategy. Some Med-Cal managed care plans have a population health management strategy, often in response to NCQA requirements, but many do not. In the absence of a strategy, care can be driven by a patchwork of requirements that can lead to gaps in access and a lack of coordination. DHCS proposes that Medi-Cal managed care plans develop and maintain a patient-centered population health strategy.  The population health management strategy is a cohesive plan of action for addressing member needs across the continuum of care, based on data driven risk stratification and standardized assessment processes. Each managed care plan would be required include, at a minimum, a description of how it will:​​ 

  • Ua kom txhua tus tswv cuab noj qab haus huv los ntawm kev tsom mus rau kev tiv thaiv thiab kev noj qab haus huv;​​ 
  • Txheeb xyuas thiab txheeb xyuas cov tswv cuab txaus ntshai thiab cov kev xav tau ntawm qhov tsis tu ncua;​​ 
  • Tswj cov tswvcuab kev nyab xeeb thiab cov txiaj ntsig tau tshwm sim thaum lub sijhawm hloov pauv, hla cov txheej txheem xa khoom lossis chaw teeb tsa, thiab los ntawm kev sib koom tes saib xyuas zoo; thiab​​ 
  • Txheeb xyuas thiab txo cov kev txiav txim hauv zej zog ntawm kev noj qab haus huv thiab txo qis kev noj qab haus huv tsis sib xws lossis kev tsis ncaj ncees.​​ 

Txoj Kev Npaj Kho Mob Txhua Xyoo Qhib Sau Npe​​ 

Lub xeev tau txiav txim siab tsis ua raws li Txoj Cai Kev Noj Qab Haus Huv Ib Xyoo Open Enrollment txoj cai. Lub tswv yim no yuav tsis yog ib lub ntsiab lus ntawm kev sib tham hauv Pawg Neeg Saib Xyuas Kev Noj Qab Haus Huv Kev Sib Tham.​​ 

Cov rooj sib tham ua haujlwm​​ 

Txhua lub rooj sib tham pab pawg neeg ua haujlwm yuav muaj nyob rau hauv Sacramento ntawm 1700 K Street nyob rau hauv Lub Rooj Sib Tham Thawj Hauv Tsev. Thov tuaj txog 10 feeb ua ntej kos npe rau ntawm lub rooj sab laj.​​ 

Kev koom tes rau pej xeem​​ 

Cov pej xeem zoo siab tos txais tuaj koom txhua lub rooj sib tham hauv xov tooj lossis ntawm tus kheej. Ib qho kev xaiv hu rau pej xeem yuav ua haujlwm rau txhua lub rooj sib tham ua haujlwm. Thov saib hauv qab no.​​ 

Nco tseg: Qhov chaw nyob hauv tus neeg raug txwv thiab yuav muab faib ua thawj zaug ua ntej. Cov tswv cuab ntawm cov pej xeem uas hu tuaj yuav raug muab tso rau hauv hom mloog nkaus xwb. Yog tias koj xav koom nrog hauv xov tooj, thov sau npe siv cov kev sib txuas hauv qab no (lub webinar yuav siv tau rau hauv xov tooj nkaus xwb). Tom qab sau npe, koj yuav tau txais email lees paub nrog koj qhov tshwj xeeb hu-hauv thiab nkag mus. CalAIM pawg neeg ua haujlwm yuav tsis raug kaw.​​ 

Lub rooj sib tham​​ 

Tiv tauj peb​​ 

For any questions or concerns about this workgroup, please contact PHMSection@dhcs.ca.gov.​​ 

Rov qab mus rau CalAIM Homepage​​