Дом Поставщики и партнеры Инициатива скоординированного медицинского обслуживания и программа Cal MediConnect​​ 

Инициатива по скоординированному уходу и Cal MediConnect​​ 

Возврат к комплексной помощи для получателей двойной помощи​​ 

Являетесь ли вы участником Cal MediConnect? Узнайте больше о будущем 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.​​ 

Основные части инициативы координированного ухода​​ 

  • Cal MediConnect: добровольный план медицинского страхования для бенефициаров, имеющих право на получение скоординированных медицинских, поведенческих, долгосрочных услуг в учреждениях, а также услуг на дому и в сообществе через единую организованную систему предоставления услуг. Cal MediConnect объединяет преимущества Medicare и Medi-Cal с дополнительными преимуществами координации медицинской помощи.​​   
  • Управляемая долгосрочная поддержка и услуги Medi-Cal (MLTSS): Все получатели Medi-Cal, включая получателей с двойным правом, в округах CCI должны присоединиться к плану управляемого медицинского обслуживания Medi-Cal, чтобы получать льготы Medi-Cal, включая LTSS и комплексные льготы 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.​​ 

Общая информация​​ 

  • 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.​​ 

Информационные бюллетени CCI​​ 

  1. Ресурсы для бенефициаров​​ 

     2. Ресурсы для поставщиков​​ 

     3. Ресурсы для адвокатов​​ 

     4. Историческая информация CCI​​ 

Принятое законодательство​​ 

Более ранние версии законодательного языка​​ 

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