协调护理计划和 Cal MediConnect
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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.
协调护理计划的主要部分
- Cal MediConnect：一项自愿健康计划，面向双重合格受益人，通过单一有组织的提供系统获得协调的医疗、行为健康、长期机构以及家庭和社区服务。 Cal MediConnect 将 Medicare 和 Medi-Cal 福利与额外的护理协调福利结合在一起。
- 管理式 Medi-Cal 长期支持和服务 (MLTSS)：CCI 县的所有 Medi-Cal 受益人（包括双重合格受益人）都必须加入 Medi-Cal 管理式医疗保健计划，才能获得 Medi-Cal 福利，包括 LTSS 和 Medicare 综合福利。
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.
一般信息
- 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 概况介绍
- 受益人资源
- Beneficiary FAQ – Includes basic FAQs about CMC for beneficiaries.
- 受益人工具包（英文）
- 受益人工具包（西班牙语）
- 耐用医疗设备会员情况说明书
- Medi-Cal 新闻：免费交通福利！
- 通过 Medi-Cal 获得牙科服务
2. 供应商资源
3. 倡导者资源
4. 历史 CCI 信息
- 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 情况说明书（2015 年 10 月）
- 协调护理计划：执行摘要（更新于 3 月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 利益相关者参与要求 ： （2012 年 8 月 30 日）利益相关者再咨询要求摘要。
- 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 费率报告
通过的立法
- CCI 预告法案参议院法案 1008 （2012 年 7 月）
- CCI Trailer Bill Senate Bill 1036 (July 2012)
立法语言的早期版本
- 对《协调护理倡议》后续法案措辞的拟议修订（5 月24 、 2012
- 解释 CCI 拖车法案语言 5 月份修订变更的情况说明书（5 月24 、 2012
- 长期支持和服务 TBL 情况说明书（3 月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.