Office of Medicare Innovation and Integration
Lub Department of Health Care Services (DHCS) Office of Medicare Innovation and Integration (OMII) muab kev coj noj coj ua thiab kev txawj ntse ntawm cov qauv tshiab rau cov neeg tau txais txiaj ntsig Medicare hauv California, suav nrog cov neeg tau txais txiaj ntsig Medicare nkaus xwb, thiab cov tib neeg muaj cai tau txais Medicare thiab Medi-Cal dua. Lub hom phiaj ntawm OMII yog txhawm rau txhim kho cov txiaj ntsig kev noj qab haus huv, kev ua tau zoo, kev them taus, thiab kev ncaj ncees rau cov neeg tau txais txiaj ntsig Medicare hauv California.
Raws li Tus Thawj Kav Tebchaws Txoj Kev Npaj rau Kev Laus, OMII yuav: 1) Txhawb nqa cov qauv tshiab thiab cov tswv yim thiab cov tswv yim tshiab kom tau txais txiaj ntsig Medicare-tsuas yog cov neeg tau txais txiaj ntsig hauv California thiab nce kev nkag mus rau Kev Pabcuam Sijhawm Ntev thiab Kev Txhawb Nqa; thiab 2) Coj thiab qhia txog DHCS cov cai rau cov neeg tau txais txiaj ntsig ob leeg tsim nyog rau Medicare thiab Medi-Cal. Qhov no suav nrog California Advancing thiab Innovating Medi-Cal (CalAIM) kev siv zog los siv kev saib xyuas kev sib koom ua ke los ntawm kev tso npe koom nrog hauv Medicare Dual-Eligible Special Needs Plans (D-SNPs) thiab Medi-Cal cov phiaj xwm, nrog rau kev nthuav dav Cov Kev Pabcuam Ntev Ntev thiab Txhawb nqa (MLTSS) rau ob tus neeg tau txais txiaj ntsig.
Rau cov neeg tau txais txiaj ntsig
Medicare Kev Tsim Nyog Rau Kev Nkag Tebchaws
ua Cov ntaub ntawv rau Cov Neeg Laus
Pab nrog Medicare Kev Sau Npe thiab Kev Xaiv
Did you know Medicare covers a variety of mental health services? For more information, please see the older adult mental health resources page.
Cov ntaub ntawv thiab cov ntaub ntawv
Cov ntsiab lus tseem ceeb:
- Kwv yees li ntawm 6.6 lab tus neeg nyob hauv California tau cuv npe hauv Medicare, suav nrog 5 lab tus neeg tau txais txiaj ntsig Medicare nkaus xwb, thiab 1.6 lab tus neeg tau txais txiaj ntsig ob leeg tsim nyog rau Medicare thiab Medi-Cal.
- Thoob plaws txhua tus neeg tau txais txiaj ntsig Medicare hauv lub xeev, kwv yees li 90 feem pua yog hnub nyoog 65 xyoos thiab laus dua, thiab 10 feem pua yog hnub nyoog qis dua 65 xyoos. Ntawm cov neeg tau txais txiaj ntsig ob leeg hauv California, kwv yees li 25 feem pua yog hnub nyoog qis dua 65 xyoos.
DHCS koom tes nrog SCAN Foundation thiab ATI Advisory los tsim ib phau ntawv qhia uas muab cov ntaub ntawv hais txog Medicare cov neeg tau txais txiaj ntsig hauv California, uas muaj hauv qab no.
Profile ntawm California Medicare Population, Hloov Kho Lub Rau Hli 6 2022
Kev Tshawb Fawb Kev Kho Mob ntawm Californians Hnub nyoog 55 thiab laus dua:
- DHCS tau koom tes nrog Lub Koom Haum SCAN rau kev tshawb fawb ntawm cov neeg California hnub nyoog 55 xyoo thiab laus dua txog kev xav tau kev kho mob thiab kev paub dhau los, uas NORC ntawm University of Chicago tau npaj. Daim ntawv ntsuam xyuas tau ua ntawm Lub Ib Hlis 25 thiab Lub Ob Hlis 10, 2022, online thiab los ntawm xov tooj, ua lus Mev thiab lus Askiv, los txiav txim siab txog cov kev xav tau kev kho mob ntawm cov neeg teb, kev sib koom tes ntawm cov kev pabcuam kev kho mob, kev paub ntawm tus neeg saib xyuas, thiab kev xav tau thiab kev nkag mus rau kev saib xyuas hauv tsev thiab cov kev pabcuam. Tag nrho muaj 1,540 tus neeg koom nrog ua tiav daim ntawv soj ntsuam. Cov qauv tsis suav nrog cov neeg laus nyob hauv cov chaw teeb tsa, xws li cov chaw saib xyuas neeg mob. Thov saib cov txiaj ntsig ntawm kev soj ntsuam ntawm Lub Koom Haum SCAN lub vev xaib.
- Cov ntaub ntawv qhia txog qhov tseeb tshiab ntawm SCAN Foundation tau txheeb xyuas cov ntsiab lus raws li lawv cuam tshuam nrog cov hauv qab no:
Txoj Cai Teebmeem
Medicare Advantage Supplemental Benefits:
- Each year Medicare Advantage (MA) plans offer supplemental benefits which are not covered benefits for Original Medicare. Supplemental benefits offered by MA plans has expanded over the past few years and includes similar benefits covered by Medi-Cal. The 2023 Medicare Advantage Supplemental Benefits Factsheet includes a comparison of MA supplemental benefits and Medi-Cal benefits including those covered in the 1915(c) Waiver, the California State Plan, and Community Supports.
ACOs:
- Cov Koom Haum Saib Xyuas Kev Noj Qab Haus Huv Medicare (ACOs) yog cov koom haum uas cov kws kho mob ua haujlwm los txhim kho qhov zoo ntawm kev kho mob, cov txiaj ntsig, thiab kev paub txog kev saib xyuas rau lawv cov neeg mob thaum txo tus nqi tag nrho ntawm kev saib xyuas. Daim ntawv qhia txog qhov tseeb no qhia txog kev piav qhia txog cov qauv Medicare ACO uas muaj feem cuam tshuam rau California, suav nrog cov yam ntxwv tseem ceeb ntawm cov qauv xaiv thiab cov lus txhais ntawm cov lus tseem ceeb. Nws tau tsim los ntawm Lub Chaw Haujlwm Saib Xyuas Kev Noj Qab Haus Huv los qhia rau California Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) cov neeg koom nrog txog cov qauv Medicare ACO uas tau pab cov neeg tau txais txiaj ntsig Medicare hauv California dhau sijhawm. Cov qauv Medicare ACO pab cov neeg tau txais txiaj ntsig Medicare hauv Original Medicare. Thov saib daim ntawv Medicare Accountable Care Organizations (ACOs) hauv California kom paub ntau ntxiv.
MLTSS:
- Under the California Advancing and Innovating Medi-Cal (CalAIM) Initiative, DHCS is expanding integrated care options and Managed Long-Term Services and Supports (MLTSS) for dually eligible beneficiaries. Please see the CalAIM MLTSS page for further details.
LTSS Public Benefit:
- The Budget Act of 2019 authorized funding for DHCS to contract with an actuarial firm to prepare a feasibility study and actuarial analysis of public long-term services and supports financing and services options for California. The final report, which contains policy options and fiscal estimates, was completed in September 2020, and is posted on the DHCS website.
Medi-Cal Kev Tshaj Tawm & Kev Sau Npe rau Cov Neeg Laus California:
- The Budget Act of 2021 authorized DHCS to implement a Medi-Cal outreach and enrollment program for older Californians.
Kab Mob Alzheimer thiab Cov Kev Mob Dementia Lwm Yam:
- Lub Chaw Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) cog lus tias yuav txhim kho kev kuaj mob, kev saib xyuas, kev txhawb nqa tus neeg saib xyuas, thiab kev tshuaj xyuas cov ntaub ntawv rau cov tib neeg uas muaj tus kab mob Alzheimer thiab cov kab mob dementia cuam tshuam. Feem ntau cov tib neeg uas muaj tus kab mob Alzheimer thiab lwm yam kev puas hlwb muaj kev pab them nqi Medicare thiab/lossis Medi-Cal. Thov saib nplooj ntawv kab mob Alzheimer thiab lwm yam kev puas hlwb kom paub ntxiv.