Txuj Ci Nursing Facility Value Strategy
DHCS is developing a comprehensive value strategy for Medi-Cal Skilled Nursing Facility (SNF) services to inform the reauthorization of the Medi-Cal Long-Term Care (LTC) Reimbursement Act (Welfare & Institutions Code (WIC) 14126, et seq.) for dates of service on or after January 1, 2027. The Medi-Cal Long-Term Care Reimbursement Act governs the overall Medi-Cal financing framework for Freestanding SNFs, and its upcoming renewal provides a historic opportunity to continue building on the CalAIM LTC Carve-in and the AB 186 Nursing Facility Financing Reform programs. The SNF Value Strategy will include a landscape analysis of payment methodologies utilized by Medi-Cal, Medicare, and other payers and a Multi-Year Roadmap to drive system transformation and integration over a five-year horizon. DHCS will engage with stakeholders throughout the development of the SNF Value Strategy.
DHCS tau tshaj tawm cov ntsiab lus hauv qab no rau SNF Tus Txheej Txheem Tus Nqi. Cov ntsiab lus qhia no yuav raug kho dua thiab kho dua tshiab los ntawm cov txheej txheem kev koom tes nrog cov koom nrog.
- Kev Koom Tes Saib Xyuas Tib Neeg thiab Kev Saib Xyuas Tag Nrho: Kev sib koom tes thiab kev saib xyuas los ntawm Medi-Cal tau tswj hwm kev saib xyuas kev noj qab haus huv los muab kev saib xyuas tag nrho rau cov tswv cuab nrog cov kev xav tau ntawm tsev kho mob thiab txhawb kev txhim kho cov Kev Pabcuam Ntev Ntev thiab Kev Txhawb Nqa (MLTSS).
- Kev lav ris zoo thiab kev txhawb siab: Tuav cov SNFs lub luag haujlwm rau kev muab kev saib xyuas zoo rau cov neeg nyob hauv thiab txhawb kev txhim kho zoo thaum txo qhov sib txawv ntawm kev noj qab haus huv raws li thiab txhawb nqa DHCS txoj Kev Npaj Zoo.
- Kev Hloov Kho Kev Kho Mob thiab Kev Txhim Kho Nyiaj Txiag: Tsim kev txhawb nqa nyiaj txiag rau kev xa kev saib xyuas hauv qhov chaw raug, suav nrog kev hloov pauv tsim nyog ntawm tsev kho mob, SNFs, thiab HCBS chaw.
- Kev Nqis Peev thiab Kev Lav Ris rau Cov Neeg Ua Haujlwm: Ua kom pom tseeb txog lub luag haujlwm tseem ceeb ntawm cov neeg ua haujlwm ua tus tsav tsheb tseem ceeb ntawm kev saib xyuas cov neeg nyob hauv tsev zoo, thiab ua kom cov chaw muaj kev lav ris rau kev siv cov nyiaj Medi-Cal los muab kev them nyiaj thiab cov txiaj ntsig ncaj ncees rau cov neeg ua haujlwm.
- Nyiaj txiag Sustainability thiab Efficiency: Kev muab kev pab cuam kev lag luam thiab muaj txiaj ntsig los txhawb kev ruaj ntseg nyiaj txiag thiab kev them taus ntawm California txoj kev kho mob.
- Kev nkag mus thiab Kev Ncaj Ncees: Txhawb kev nkag mus rau cov chaw tu neeg mob uas muaj kev txawj ntse, suav nrog hauv thaj chaw nyob deb nroog, thiab tshem tawm cov kev tsis txaus siab hauv cov neeg nyob hauv kev nkag mus, hloov mus, thiab tawm mus.
DHCS tau xaiv Mathematica thiab Myers thiab Stauffer ua tus kws pab tswv yim los txhawb txoj haujlwm no.
Stakeholder Engagement
DHCS tab tom sib tham Pawg Neeg Sawv Cev Tawm Tswv Yim Pab Pawg los pab hauv kev txhim kho SNF Tus Tswv Yim Zoo. Cov tib neeg uas raug xaiv los koom nrog Pawg Neeg Ua Haujlwm tau raug xaiv los ntawm kev hu xov tooj rau pej xeem thiab yog lub hom phiaj los qhia txog qhov nyuaj thiab dav ntawm lub kaw lus SNF, suav nrog cov neeg ua haujlwm hauv chaw kho mob thiab cov thawj coj, cov phiaj xwm kev saib xyuas uas tau tswj hwm, cov neeg ua haujlwm hauv chaw kho mob thiab cov neeg sawv cev rau cov neeg ua haujlwm, cov neeg tawm tswv yim rau cov neeg siv khoom, cov neeg mob thiab cov tswv cuab hauv tsev neeg uas muaj kev paub dhau los, thiab cov kws kho mob saib xyuas mus sij hawm ntev thiab cov kws tshaj lij txoj cai.
Ntxiv nrog rau kev sib tham rau Pawg Neeg Ua Haujlwm, DHCS yuav muab cov kev hloov tshiab tsis tu ncua rau cov neeg muaj feem cuam tshuam los ntawm kev sib tham txhua lub sijhawm los ntawm cov neeg tuaj sib tham thiab los ntawm lwm lub rooj sib tham muaj feem cuam tshuam.
Cov Rooj Sib Tham Rau Peb Sawv Daws
Kev Sib Tham Hauv Is Taws Nem rau Cov Neeg Tuaj Koom #1
Hnub Tim: Hnub Friday, Lub Ob Hlis Ntuj 20, 2026
Lub Sijhawm: 9:30 – 11:00 sawv ntxov
Please register to receive teleconference information: https://events.gcc.teams.microsoft.com/event/1eaccc15-976d-4212-a090-3cebc2d9cf73@265c2dcd-2a6e-43aa-b2e8-26421a8c8526
Cov hauj lwm cuam tshuam
LTC Cov Nqi Them Rov Qab
Current LTC reimbursement rates and policy information is available on the Long Term Care Reimbursement webpage.
CalAIM LTC Carve-In
As part of the CalAIM initiative, DHCS standardized and integrated coverage of LTC services by Managed Care Plans statewide effective January 1, 2023 and January 1, 2024. Visit the CalAIM LTC Carve-in webpage for more information.
Kev Kho Mob Kev Kho Mob Nyiaj Txiag (AB 186)
DHCS implemented several new Nursing Facility Financing programs pursuant to AB 186 between 2022 and 2024 including the Workforce & Quality Incentive Program (WQIP), Workforce Standards Program (WSP), and Accountability Sanctions Program (ASP). The future of these programs, as well as lessons learned, will be considered as part of the SNF Value Strategy. To access historical materials related to this work, visit the Nursing Facility Financing Reform (AB 186) webpage.
Nyob Txuas
To receive updates on the SNF Value Strategy and relate programs, sign up for the e-mail distribution list.
Cov lus nug
To submit questions about the SNF Value Strategy, send an email to: SNFValueStrategy@dhcs.ca.gov., or by mail to the following address:
Department of Health Care Services
Ceeb Toom: Tus Thawj Coj, LTSS Financing Branch
Chav Haujlwm Tsim Kho Tus Nqi Muab Kev Pabcuam
1501 Capitol Avenue, MS 4600
PO ib 997417
Sacramento, CA 95899-7417