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Bumalik sa April 2022 Stakeholder Communications Update
Ikalawang Ulat sa Pagsusuri ng Health Homes Program (HHP).
On March 29, DHCS released the second HHP Interim Evaluation Report, which was independently developed by UCLA’s Center for Health Policy Research supported by The California Endowment. HHP was authorized under AB 361 (Chapter 642, Statutes of 2013) and approved by CMS under Section 2703 of the 2010 Patient Protection and Affordable Care Act.
Noong 2018, ipinatupad ng DHCS ang HHP upang pagsilbihan ang mga kwalipikadong miyembro ng Medi-Cal MCP na may mga kumplikadong pangangailangan, kabilang ang mga indibidwal na may malalang kondisyon at mataas na antas ng paggamit ng serbisyo. Ang HHP ay pinamamahalaan sa 12 county ng California ng 16 na MCP na nakikipagkontrata sa Community-Based Care Management Entities (CB-CMEs). Paglubog ng araw ang HHP noong Disyembre 31, 2021, at inilipat sa benepisyo ng ECM, ngunit tinutupad ng DHCS ang pangako nitong gumawa ng mga natitirang independiyenteng pagsusuri ng HHP.
DHCS released the first Interim HHP Evaluation Report in fall 2021. This second HHP interim evaluation report builds upon the findings of the first report and provides updates to enrollment patterns, demographics, and services HHP enrollees received originally reported in the first interim evaluation report. The second report also categorizes HHP enrollees based on their utilization of acute care services prior to HHP enrollment. The five distinct categories include enrollees considered super utilizers (6 percent of all enrollees), high utilizers (15 percent), moderate utilizers (35 percent), low utilizers (32 percent), and enrollees at risk for being a high utilizer (13 percent). UCLA found that enrollees considered super utilizers had 14.9 emergency department (ED) visits and 4.1 hospitalizations on average per year. Additionally, the second report also includes analyses of changes in HHP core metrics and estimated Medi-Cal payment measures compared to a control group. Findings indicated some improvements in metrics compared to the control. In particular, UCLA found greater declines for HHP participants in core metrics, such as ED visits and hospitalization rates, that were significantly greater compared to the control group. The final evaluation report will assess longer-term health outcomes and utilization trends of HHP enrollees and will be completed in spring 2023.