2022年4月に戻る ステークホルダーコミュニケーションの最新情報​​ 

DHCSカバレッジアンバサダー​​ 

DHCSは、Medi-Calの受益者がMedi-Calの補償範囲を維持したり、他の補償範囲に登録したりできるように、州全体の取り組みを開始しました。​​ 

In the largest effort of its kind, across the country, Medicaid (e.g., Medi-Cal) and the Children’s Health Insurance Program will soon begin the process of redetermining eligibility for about 85 million people who use these programs to access the health care they need. This large, complex effort will be triggered by the official end of the COVID-19 public health emergency (PHE) and the end of the federal Medicaid continuous coverage requirement that was implemented as part of the Families First Coronavirus Response Act.​​ 

カリフォルニア州が通常のMedi-Calの適格性運用を再開する予定であるため、約1,450万人の受益者が補償の適格性を再決定する必要があります。 PHEの終了時に、郡は、次の年次更新日に基づいて、すべての受益者のMedi-Calの適格性を再決定します(一度にすべてではなく、ローリングベースで行われます)。 そのプロセスの結果、200万人から300万人の受益者がMedi-Calの資格を失う可能性があります。​​ 

DHCS has been actively preparing for this unprecedented event for many months, and has implemented a two-phased communication campaign to reach beneficiaries with messages across multiple channels using trusted partners called DHCS Coverage Ambassadors. DHCS encourages its partners, including local county social services agencies, managed care plans (MCPs), health enrollment navigators, clinics, providers, and community stakeholders, to sign up to serve as DHCS Coverage Ambassadors.​​ 

For Phase 1 of the campaign, DHCS recently launched a customizable Medi-Cal Continuous Coverage toolkit and webpage to help trusted entities and individuals act as DHCS Coverage Ambassadors to provide critical information to beneficiaries and to help preserve health coverage for millions. The toolkit includes social media, call scripts, noticing, and website banners. During Phase 1, trusted entities and individuals encourage beneficiaries to update their contact information with their local county offices, if they have not done so already. Beneficiaries need to know what to expect and what they can do to keep their Medi-Cal health coverage. Those no longer eligible for Medi-Cal may qualify for tax subsidies that allow them to buy affordable Covered California coverage.​​ 

フェーズ2は、COVID-19 PHEの終了の約60日前に開始される予定で、受益者が連絡先情報を更新し、状況の変化を地元の郡役所に報告し、今後の更新パケットについてメールを確認することを奨励するように設計されています。 追加のツールキットやリソースが利用可能になると、DHCSは重要な更新を電子メールで送信し、DHCSカバレッジアンバサダーに情報を提供し、彼らが言葉を広めることができるようにします。​​ 

DHCSは、COVID-19 PHEを乗り越えるための一歩を共に進めるために、情報を共有し、お客様からのフィードバックを聞くことが重要であることを理解しています。 受益者が健康保険を維持または移行するために何を、そしていつ行う必要があるかを知るために、私たち全員が協力して取り組む必要があります。 今後ともご協力を賜りますよう、よろしくお願いいたします。​​ 

Medi-Cal COVID-19ワクチン接種インセンティブプログラム​​ 

DHCS allocated up to $350 million to incentivize COVID-19 vaccination efforts in the Medi-Cal managed care delivery system from September 1, 2021, through February 28, 2022. Medi-Cal MCPs are eligible to earn incentive payments for activities designed to close vaccination gaps with their enrolled members, and to address vaccine uptake disparities for specific age and race/ethnicity groups. The second outcome ascertainment period for the program ended on January 2. Between November 1 and January 2, the total vaccination rates showed improvement in all reported measures. Statewide, the target (59.2 percent) was exceeded (61.4 percent) for improving the percentage of primary care providers in MCP networks giving the COVID-19 vaccine in their office. On January 2, target goals for all vaccine outcome measures increased to closing two-thirds of the gap between Medi-Cal and county rates, which was a challenge for plans to meet. Three beneficiary sub-groups (ages 12-25 years, African-Americans, and American Indians/Alaska Natives) were successful in closing more than one-third of the gap at this time point, while an additional three groups (overall age 12+ years, 50-64 years, and 65+ years) were within 2 percent of closing one-third of the gap. Specifications for the High Performance Pool program were released to MCPs. For more information, please refer to All Plan Letter (APL) 21-010, Attachment A.​​ 

高齢者向け拡張パック​​ 

On May 1, California will expand state-funded full-scope Medi-Cal benefits to individuals who are 50 years of age or older, regardless of citizenship or immigration status. This coverage expansion includes approximately 185,000 individuals 50 years of age or older who are currently enrolled in restricted scope Medi-Cal.  Under this coverage expansion, eligible individuals will be able to access the full range of benefits available to Medi-Cal beneficiaries who have full-scope coverage, including no-cost/low-cost quality health, behavioral health, substance use disorder services, and dental services through organized delivery systems under the Medi-Cal program. Enrolled individuals in restricted-scope Medi-Cal who are eligible under this expansion will receive a My Medi-Cal Choice packet in the mail so they can enroll in a Medi-Cal managed care plan for coordinated, integrated medically necessary services. Once enrolled in a plan, they can select a primary care doctor in their plan network. For more information, please visit the DHCS website.​​ 

55歳以上のカリフォルニア州民を対象としたヘルスケア調査​​ 

In April, DHCS will release the results from a survey of California adults ages 55 and older on health care needs, services, and coverage, including Medicare, Medi-Cal, and other health coverage. The survey included questions about respondents’ medical needs, coordination of and access to health care services, caregiver experiences, and the need for and access to in-home care and services. Interviews for this survey were conducted between January 25 and February 10, 2022. A total of 1,540 individuals completed the survey. It was administered by NORC at the University of Chicago, with funding from The SCAN Foundation and oversight from DHCS’ Office of Medicare Innovation and Integration. The survey results will be posted on the DHCS website.​​