ព័ត៌មានកំពូល
ត្រលប់ទៅខែកុម្ភៈ ឆ្នាំ 2022 បច្ចុប្បន្នភាពទំនាក់ទំនងអ្នកពាក់ព័ន្ធ
សំណើគម្រោងថែទាំដែលគ្រប់គ្រងសម្រាប់សំណើ (RFP) អាប់ដេត
On February 9, DHCS released a RFP for its commercial Medi-Cal managed care plan (MCP) contractors that will redefine how care is delivered to more than 12 million Californians. The RFP raises the state’s expectations of MCPs in the Medi-Cal program through a new and strengthened contract that will apply to all plans. This unprecedented Medi-Cal plan procurement, when implemented, will transform health care delivery for Californians enrolled in Medi-Cal managed care.
DHCS កំពុងស្វែងរកដៃគូ MCP ប្តេជ្ញាជំរុញសមធម៌ គុណភាព លទ្ធភាពទទួលបាន គណនេយ្យភាព និងតម្លាភាព ដើម្បីកាត់បន្ថយវិសមភាពសុខភាព និងកែលម្អលទ្ធផលថែទាំសុខភាពសម្រាប់សមាជិក Medi-Cal ។ MCPs ដែលបានជ្រើសរើសនឹងប្តេជ្ញាចំពោះតម្រូវការថ្មី និងប្រសើរឡើង ដើម្បីធានាថាសមាជិកអាចទទួលបានសេវាថែទាំសុខភាពសមស្របនៅពេលចាំបាច់ រួមទាំងជំនួយផ្នែកសង្គម និងសេវាគ្រប់គ្រងការថែទាំដែលមានសារៈសំខាន់ក្នុងការជំរុញការកែលម្អសុខភាពប្រជាជន និងសមធម៌សុខភាព។ តាមរយៈដំណើរការ RFP DHCS កំពុងកែលម្អការត្រួតពិនិត្យដៃគូផែនការ និងអ្នកម៉ៅការបន្តរបស់ពួកគេ ដើម្បីធានាបាននូវតម្លាភាព និងគណនេយ្យភាពកាន់តែច្រើន។
The RFP procurement is part of a larger set of state investments in the health and well-being of all Californians that includes CalAIM. Proposals from MCPs are due on April 11, 2022. DHCS will award contracts by fall 2022, and new contracts are scheduled to begin on January 1, 2024.
On February 15, DHCS hosted an all-comers webinar for members, advocates, providers, health plans, and other stakeholders to share how DHCS will leverage the MCP RFP and managed care contracts to further DHCS’ goals to enhance how care is delivered to Medi-Cal members.
On February 24, DHCS will host a voluntary pre-proposal web conference from 1 – 2:30 p.m. specifically for the MCP procurement and the RFP released on February 9; Register for the RFP web conference
សូមចូលទៅកាន់គេហទំព័រលទ្ធកម្ម MCP សម្រាប់ព័ត៌មានបន្ថែម។ Visit the RFP webpage to view the RFP.
ការធ្វើបច្ចុប្បន្នភាពការអនុវត្ត Medi-Cal Rx
On January 1, DHCS transitioned the Medi-Cal pharmacy benefit of more than 14 million Medi-Cal members to a single delivery system, a change that will benefit members and result in substantial savings. As is the case with any large project, some implementation issues were to be expected, and DHCS’ vendor, Magellan, is addressing those as quickly as possible. DHCS is also ensuring that providers are kept updated, and that relevant information is communicated to them via e-mail blasts, provider newsflashes, information on the DHCS and Medi-Cal Rx websites, and direct provider outreach. Our actions are designed to ensure that Medi-Cal members can get the prescription drugs they need when they need them. For questions or comments related to Medi-Cal Rx, please email RxCarveOut@dhcs.ca.gov.
កាលីហ្វញ៉ា ជំរុញ និងច្នៃប្រឌិត Medi-Cal (CalAIM) បច្ចុប្បន្នភាព
On December 29, 2021, DHCS received approval of the CalAIM Section 1115 Demonstration, CalAIM Section 1915(b) waiver, and Medi-Cal State Plan Amendments from the federal Centers for Medicare & Medicaid Services (CMS). These approvals provide the authority to launch CalAIM, a long-term commitment to transform and strengthen Medi-Cal – the cornerstone of California’s health care system.
CalAIM shifts Medi-Cal to a population health approach, prioritizing prevention, addressing social drivers of health, and transforming services for communities who historically have been under-resourced and faced structural racism in the health care system. CalAIM is a bold transformation, putting people’s needs at the center of care and setting the pace for transformation of the entire health care sector.
On January 14, DHCS hosted a webinar to provide an overview of the recently approved CalAIM Section 1115 Demonstration and 1915(b) waiver. View the January 14 CalAIM Section 1115 demonstration 1915(b) waiver presentation.
កម្មវិធីលើកទឹកចិត្តក្នុងការចាក់វ៉ាក់សាំង COVID-19 របស់ Medi-Cal
DHCS កំពុងបែងចែករហូតដល់ 350 លានដុល្លារ ដើម្បីលើកទឹកចិត្តដល់កិច្ចខិតខំប្រឹងប្រែងចាក់វ៉ាក់សាំង COVID-19 នៅក្នុងប្រព័ន្ធផ្តល់ការថែទាំដែលគ្រប់គ្រងដោយ Medi-Cal ចាប់ពីខែកញ្ញា 1, 2021 រហូតដល់ថ្ងៃទី 28 ខែកុម្ភៈ, 2022 ។ MCPs Medi-Cal មានសិទ្ធិទទួលបានការទូទាត់លើកទឹកចិត្តសម្រាប់សកម្មភាពដែលត្រូវបានរចនាឡើងដើម្បីបិទគម្លាតនៃការចាក់ថ្នាំបង្ការជាមួយសមាជិកដែលបានចុះឈ្មោះរបស់ពួកគេ និងដើម្បីដោះស្រាយភាពខុសគ្នានៃការទទួលថ្នាំបង្ការសម្រាប់ក្រុមអាយុ និងពូជសាសន៍/ជនជាតិជាក់លាក់។ MCPs អាចរកចំណូលបានរហូតដល់ 50 លានដុល្លារសម្រាប់ការសម្រេចបាននូវវិធានការដំណើរការដែលបានបញ្ជាក់ និង $200 លានដុល្លារសម្រាប់វិធានការលទ្ធផល ជាមួយនឹង 100 លានដុល្លារសម្រាប់ MCPs ដើម្បីប្រើប្រាស់សម្រាប់ការលើកទឹកចិត្តសមាជិកដោយផ្ទាល់។
Effective September 1, 2021, all 25 full-service MCPs and one population-specific health plan were approved for participation in the program. The first outcome ascertainment period ended on October 31. Between September 1 and October 31, all plans reported improvement in all three intermediate outcome measures and all seven vaccine uptake outcome measures. Statewide, the target for Measure 3 was exceeded, improving the percentage of primary care providers in MCP networks providing COVID-19 vaccine in their office from 49.3 percent to 56.8 percent. In addition, almost one-third of the gap in COVID-19 vaccination rates between the Medi-Cal and overall California populations ages 12-25 was closed, and almost one-third of the gap in COVID-19 vaccination rates between the overall Medi-Cal population and both the Black/African American and American Indian/Alaska Native Medi-Cal populations was closed. Vaccination rates continued to improve through the second outcome ascertainment date of January 2, 2022, but statewide did not meet DHCS’ goal of closing two-thirds of the gap for any of the seven vaccine update outcome measures. January 2 data for the three intermediate outcome measures are being compiled.