2022년 4월 이해관계자 커뮤니케이션 업데이트로 돌아가기​​ 

DHCS 커버리지 앰배서더​​ 

DHCS는 메디칼 수혜자가 메디칼 보험을 유지하거나 다른 보험에 가입할 수 있도록 돕기 위해 주 전역에 걸친 노력을 시작했습니다.​​ 

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.​​ 

캘리포니아가 정상적인 메디칼 자격 운영을 재개할 계획이므로 약 1,450만 명의 수혜자는 보장 자격을 다시 결정해야 합니다. PHE가 종료되면 카운티는 다음 연례 갱신일을 기준으로 모든 수혜자에 대한 메디칼 자격을 다시 결정합니다(한 번에 모두 결정하지 않고 순차적으로 결정). 그 결과 200만~300만 명의 수혜자가 더 이상 Medi-Cal을 받을 수 없게 되었습니다.​​ 

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.​​ 

2단계는 코로나19 PHE가 종료되기 약 60일 전에 시작될 예정이며, 수혜자들이 연락처 정보를 업데이트하고 상황 변화를 지역 카운티 사무실에 보고하도록 독려하고, 향후 갱신 패킷이 우편으로 발송되는지 확인하도록 설계되었습니다. 추가 툴킷이나 리소스가 제공되면 DHCS는 DHCS 커버리지 앰배서더에게 이메일을 보내 중요한 업데이트를 알리고 이를 널리 알릴 수 있도록 할 것입니다.​​ 

DHCS는 코로나19 PHE를 넘어서기 위한 조치를 함께 취하면서 정보를 공유하고 여러분의 피드백을 듣는 것이 중요하다는 것을 알고 있습니다. 수혜자가 건강 보험을 유지하거나 전환하기 위해 언제, 무엇을 해야 하는지 알 수 있도록 우리 모두가 협력하여 도와야 합니다. 지속적인 파트너십에 감사드립니다.​​ 

Medi-Cal COVID-19 백신 접종 인센티브 프로그램​​ 

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.​​ 

고령자 확장​​ 

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.​​ 

55세 이상 캘리포니아 주민을 대상으로 한 건강 관리 설문 조사​​ 

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.​​