코디네이트 케어 이니셔티브 및 Cal MediConnect
Cal MediConnect 회원이신가요? Cal MediConnect의 미래에 대해 자세히 알아보세요.
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.
코디네이트 케어 이니셔티브의 주요 부분
- Cal MediConnect: 이중 자격 수혜자가 단일 조직화된 전달 시스템을 통해 조정된 의료, 행동 건강, 장기 시설, 가정 및 지역 사회 기반 서비스를 받을 수 있는 자발적 의료 보험입니다. Cal MediConnect Medicare 및 Medi-Cal 혜택과 추가 케어 코디네이션 혜택이 결합되어 있습니다.
- 관리되는 장기 지원 및 Medi-Cal 서비스(MLTSS): CCI 카운티의 이중 자격 Medi-Cal 수혜자를 포함한 모든 수혜자는 의료 보험에 Medi-Cal Managed Care Medi-Cal LTSS Medicare 가입해야 및 랩 어라운드 혜택을 포함한 혜택을 받을 수 있습니다.
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.
일반 정보
- 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.
CCI 팩트 시트
- 수혜자를 위한 리소스
- Beneficiary FAQ – Includes basic FAQs about CMC for beneficiaries.
- 수혜자 툴킷 (영어)
- 수혜자 툴킷 (스페인어)
- 내구성이 뛰어난 의료 장비 회원 팩트 시트
- Medi-Cal 뉴스: 무료 교통편 혜택!
- 다음을 통한 치과 서비스 Medi-Cal
2. 제공자를 위한 리소스
3. 옹호자를 위한 리소스
4. 과거 CCI 정보
- Background on the CCI – Contains brief background information on the CCI and five FAQs about the CCI
- What is Cal MediConnect? – A brief overview of Cal MediConnect (CMC), including which benefits are coordinated and information about how to join.
- Managed Long-Term Services and Supports (MLTSS) page –Includes brief information about MLTSS, a link to find an MLTSS plan, and three MLTSS FAQs.
- CCI-HIV 팩트 시트 (2015년 10월)
- 코디네이트 케어 이니셔티브: 요약 (3월 업데이트 27, 2013)
- CCI Population Chart: Updated table showing groups included in and excluded from the demonstration and mandatory Medi-Cal enrollment (March 27, 2013)
- CCI Population Summary: (March 27, 2013) A summary of the participating populations
- CCI Beneficiary Protections: (August 30, 2012) A summary of all the beneficiary protections included in the CCI.
- CCI Legislative Reporting Requirements: (August 30, 2012) A summary of the legislative reporting requirements for the CCI.
- CCI 이해관계자 참여 요구 사항 (2012년 8월 30일) 이해관계자 재협의 요건 요약.
- CCI Evaluation Strategy: (October 12, 2012) An overview of the evaluation and quality monitoring for the duals demonstration.
- CCI’s Commitment to Quality: (October 12, 2012) An overview of State efforts to advance high quality care delivery.
- Cal MediConnect 요금 보고서
채택된 법률
- CCI 트레일러 법안 상원 법안 1008 (2012년 7월)
- CCI Trailer Bill Senate Bill 1036 (July 2012)
이전 버전의 입법 언어
- 코디네이트 케어 이니셔티브 트레일러 법안 문구 개정안 (5월 24, 2012
- 5월 개정된 CCI 트레일러 법안 문구 변경 사항을 설명하는 팩트 시트 (5월 24, 2012
- 장기 지원 및 서비스 TBL 팩트 시트 (3월 26, 2012
- Legislative Language on the Brown Administration’s Coordinated Care Initiative (March 26, 2012)
- Savings Estimates and Methodology for the Coordinated Care Initiative (February)
For more information about the Coordinated Care Initiative and Cal MediConnect, please visit the Integrated Care for Dual Eligible Beneficiaries webpage.