ផ្ទះ អ្នកផ្តល់សេវា និងដៃគូ គំនិតផ្តួចផ្តើមថែទាំសម្របសម្រួល និង Cal MediConnect​​ 

Coordinated Care Initiative និង Cal MediConnect​​ 

ត្រឡប់ទៅការថែទាំរួមបញ្ចូលគ្នាសម្រាប់អ្នកទទួលផលដែលមានសិទ្ធិពីរ​​ 

តើអ្នកជាសមាជិក Cal MediConnect ទេ? ស្វែងយល់បន្ថែមអំពីអនាគតរបស់ Cal MediConnect។​​ 

Passage of the Coordinated Care Initiative (CCI) in July 2012 marked an important step toward transforming California’s Medi-Cal (Medicaid) care delivery system to better serve the state’s low-income seniors and persons with disabilities. Building upon many years of stakeholder discussions, the CCI begins the process of integrating delivery of medical, behavioral, and long-term care services and provides a road map to integrate Medicare and Medi-Cal for beneficiaries of both programs, called “dual eligible” beneficiaries.​​   

Created through a public process involving stakeholders and health care consumers, the CCI was enacted through Senate Bill 1008 (Chapter 33, Statutes of 2012) and Senate Bill 1036 (Chapter 45, Statutes of 2012).​​ 

The CCI was implemented in seven counties beginning in 2014. The seven counties are Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara.​​ 

ផ្នែកសំខាន់ៗនៃគំនិតផ្តួចផ្តើមការថែទាំដែលសម្របសម្រួល​​ 

  • Cal MediConnect៖ ផែនការសុខភាពស្ម័គ្រចិត្តសម្រាប់អ្នកទទួលផលដែលមានសិទ្ធិពីរ ដើម្បីទទួលបានការសម្របសម្រួលផ្នែកវេជ្ជសាស្ត្រ សុខភាពអាកប្បកិរិយា សេវាស្ថាប័នរយៈពេលវែង និងតាមផ្ទះ និងសហគមន៍តាមរយៈប្រព័ន្ធចែកចាយដែលមានការរៀបចំតែមួយ។ Cal MediConnect រួមបញ្ចូលគ្នាទាំងអត្ថប្រយោជន៍ Medicare និង Medi-Cal ជាមួយនឹងអត្ថប្រយោជន៍នៃការសម្របសម្រួលការថែទាំបន្ថែម។​​   
  • គ្រប់គ្រង Medi-Cal ជំនួយ និងសេវាកម្មរយៈពេលវែង (MLTSS)៖ អ្នកទទួលផល Medi-Cal ទាំងអស់ រួមទាំងអ្នកទទួលផលដែលមានសិទ្ធិពីរ នៅក្នុងតំបន់ CCI តម្រូវឱ្យចូលរួមជាមួយគម្រោងថែទាំសុខភាពដែលគ្រប់គ្រងដោយ Medi-Cal ដើម្បីទទួលបានអត្ថប្រយោជន៍ Medi-Cal របស់ពួកគេ រួមទាំង LTSS និងអត្ថប្រយោជន៍រុំជុំវិញ Medicare ។​​ 

What’s New with Cal MediConnect​​ 

Under the California Advancing and Innovating Medi-Cal (CalAIM) initiative, starting on January 1, 2023, Cal MediConnect members will be transitioned to MMPs, or Medi-Medi Plans. MMPs is the California-specific program name for Exclusively Aligned Enrollment Dual Eligible Special Needs Plans (EAE D-SNPs). Under exclusively aligned enrollment, beneficiaries can enroll in a D-SNP for Medicare benefits and in a Medi-Cal managed care plan for Medi-Cal benefits, which are both operated by the same parent organization for better care coordination and integration. DHCS will work with health plans, stakeholders, and the Centers for Medicare & Medicaid Services (CMS) to transition and expand integrated care statewide.  This policy is intended to help meet the statewide goals of improved care integration and person-centered care, under both the CalAIM initiative and the California Master Plan for Aging.​​ 

DHCS is convening the monthly public CalAIM MLTSS & Duals Integration Workgroup to work with stakeholders to support this transition. Information on how to register for the CalAIM MLTSS & Duals Integration Stakeholder Workgroup, and background materials from previous workgroup meetings is available here.​​ 

ព័ត៌មាន​ទូទៅ​​ 

  • How to Enroll – Shares basic information about how to enroll in Cal MediConnect.​​ 
  • Cal MediConnect Benefits and Services – Includes basic information about CMC’s benefits/services.​​ 
  • PACE – Includes brief background on the PACE program, a link to CalPACE, and four PACE FAQs.​​ 
  • Health Plan 101 – An explanation of different health plan components and a series of related questions and answers.​​ 

សន្លឹកការពិត CCI​​ 

  1. ធនធានសម្រាប់អ្នកទទួលផល​​ 

     2. ធនធានសម្រាប់អ្នកផ្តល់សេវា​​ 

     3. ធនធានសម្រាប់អ្នកតស៊ូមតិ​​ 

     4. ព័ត៌មានប្រវត្តិសាស្ត្រ CCI​​ 

ច្បាប់ដែលបានអនុម័ត​​ 

កំណែមុននៃភាសានីតិប្បញ្ញត្តិ​​ 

For more information about the Coordinated Care Initiative and Cal MediConnect, please visit the Integrated Care for Dual Eligible Beneficiaries webpage.​​