专业护理机构价值策略
DHCS is developing a comprehensive value strategy for Medi-Cal Skilled Nursing Facility (SNF) services to inform the reauthorization of the Medi-Cal Long-Term Care (LTC) Reimbursement Act (Welfare & Institutions Code (WIC) 14126, et seq.) for dates of service on or after January 1, 2027. The Medi-Cal Long-Term Care Reimbursement Act governs the overall Medi-Cal financing framework for Freestanding SNFs, and its upcoming renewal provides a historic opportunity to continue building on the CalAIM LTC Carve-in and the AB 186 Nursing Facility Financing Reform programs. The SNF Value Strategy will include a landscape analysis of payment methodologies utilized by Medi-Cal, Medicare, and other payers and a Multi-Year Roadmap to drive system transformation and integration over a five-year horizon. DHCS will engage with stakeholders throughout the development of the SNF Value Strategy.
DHCS 为 SNF 价值战略提出了以下指导原则。这些指导原则可能会在利益相关者参与过程中进一步修改和完善。
- 全人護理和護理協調：通过加州医疗保险管理性护理服务系统协调和整合护理，为有机构级护理需求的成员提供全人护理，并支持发展全面的管理性长期服务和支持（MLTSS）。
- 质量问责与激励：要求 SNF 负责提供高质量的居民护理，并激励其提高质量，同时减少健康差距，以配合并推进 DHCS 的全面质量战略。
- 护理过渡和财务调整：为在合适的环境中提供护理服务制定财务激励措施，包括在医院、SNF 和 HCBS 环境之间进行适当的过渡。
- 劳动力投资和问责制：强调劳动力作为高质量居民护理关键驱动力的重要作用，并要求医疗机构负责使用 Medi-Cal 资金为工人提供公平的补偿和福利。
- 财务可持续性和效率：经济高效地提供服务，支持加州医疗系统的财务可持续性和可负担性。
- 获取和系统完整性：支持充分获得专业护理机构的护理服务，包括在农村地区，并消除居民入院、转院和出院方面的不正当激励措施。
DHCS 已选择 Mathematica 和 Myers and Stauffer 作为支持这项工作的顾问。
利益相关方参与
DHCS 正在召集一个利益相关者咨询工作组，以协助制定 SNF 价值战略。参加工作组的人员是通过公开征集提名选出的，旨在反映 SNF 系统的复杂性和广泛性，包括设施运营商和管理者、管理性护理计划、设施工人和劳工代表、消费者权益倡导者、有生活经验的患者和家庭成员，以及长期护理临床医生和政策专家。
除了召集一个专门的工作组外，健康与社会服务部还将通过定期的全体成员网络研讨会和其他现有的利益相关者论坛，定期向利益相关者提供最新信息。
公开会议
公开全员网络研讨会 #1
日期星期五，2 月20 、2026
时间：上午 9:30 - 11:00
Please register to receive teleconference information: https://events.gcc.teams.microsoft.com/event/1eaccc15-976d-4212-a090-3cebc2d9cf73@265c2dcd-2a6e-43aa-b2e8-26421a8c8526
相关工作
长期护理补偿标准
Current LTC reimbursement rates and policy information is available on the Long Term Care Reimbursement webpage.
CalAIM LTC Carve-In
As part of the CalAIM initiative, DHCS standardized and integrated coverage of LTC services by Managed Care Plans statewide effective January 1, 2023 and January 1, 2024. Visit the CalAIM LTC Carve-in webpage for more information.
护理机构融资改革（AB 186）
DHCS implemented several new Nursing Facility Financing programs pursuant to AB 186 between 2022 and 2024 including the Workforce & Quality Incentive Program (WQIP), Workforce Standards Program (WSP), and Accountability Sanctions Program (ASP). The future of these programs, as well as lessons learned, will be considered as part of the SNF Value Strategy. To access historical materials related to this work, visit the Nursing Facility Financing Reform (AB 186) webpage.
保持联系
To receive updates on the SNF Value Strategy and relate programs, sign up for the e-mail distribution list.
问题
To submit questions about the SNF Value Strategy, send an email to: SNFValueStrategy@dhcs.ca.gov., or by mail to the following address:
Department of Health Care Services
Attention：LTSS 融资处处长
提供方费率开发部
1501 国会大道，密西西比州 4600
邮局 信箱 997417
萨克拉门托，加利福尼亚州 95899-7417