캘리포니아 아동 서비스 시범 프로젝트
The 1115 “Bridge to Reform” Waiver (Waiver) renewal of November 2010 was intended to identify and test alternative health care delivery models for the California Children’s Services (CCS) program. A CCS Demonstration Project (DP) was pursued to test the efficacy of transitioning the CCS program from a fee-for-service based health care delivery model to an organized health care delivery model with a capitated payment. The CCS DP tests new approaches to improve the quality of care provided to children (up to 21 years of age) with special health care needs and focuses on identifying and solving roadblocks to access to care and ensuring families receive appropriate health care services for their child or youth.
CCS DP의 목표는 다음과 같습니다:
- 치료 조정을 개선하고 파편화된 의료 서비스 제공을 제거합니다;
- 건강 결과를 개선하세요;
- 환자 및 의료진 만족도 향상
- 명확한 제공자 및 국가 책임을 확립합니다;
- 가족 중심의 전달 체계 유지, 그리고
- 기존 CCS 지역 공급자 네트워크를 유지합니다.
On April 1, 2013 the Health Plan of San Mateo (HPSM), in partnership with the San Mateo County Health System, became the first operational CCS DP pilot under the Waiver. DHCS selected the HPSM to participate in the CCS DP pilot under a full risk Medi-Cal Managed Care Plan model to improve the county’s CCS program through enhanced care coordination. The HPSM provides comprehensive health care to approximately 1,400 CCS eligible clients, and manages and coordinates a full range of health care services for the “whole” child including periodic health assessments, immunizations, primary health care services not related to the CCS eligible medical condition and specialty health care services.