六月 3, 2025​​ 

Sacramento —— California Department of Health Care Services (DHCS) ) 今天宣布，有數據顯示Medi-Cal社區支持計劃是成功且具有成本效益的。 數據顯示，社區支持正在履行其滿足 Medi-Cal 成員需求的承諾——減少可避免的急診就診、住院和長期護理使用，同時顯示出強勁的早期成本節約跡象。研究的 12 項社區支持措施均能降低成本，其中 9 項已在初步研究期間證明了其成本效益。其餘三個項目預計將在更長的研究期內達到該閾值，這符合聯邦政府評估成本效益的規定。​​ 

“Community Supports represent a fundamental shift in how we deliver health care to Californians, enhancing quality of care for Medi-Cal members and strengthening the overall efficiency and equity of our health care system,” said DHCS Director Michelle Baass. “These findings confirm that these services are not only improving lives, but also reducing avoidable health care costs. By scaling these supports statewide, we’re making meaningful progress toward a person-centered Medi-Cal system that meets members where they are and prioritizes prevention, dignity, and value.”​​ 

California’s Community Supports were approved in the California Advancing and Innovating Medi-Cal (CalAIM) waivers and phased in by Medi-Cal managed care plans (MCP) beginning in 2022. CalAIM is the state’s initiative to transform Medi-Cal to improve care quality, reduce complexity, and advance equity through data-driven, whole-person care initiatives.​​ 

為什麼這很重要： Medi-Cal 目前提供 14 項社區支持服務。這些服務有助於提高住房穩定性，緩解從機構環境過渡到家庭護理的壓力，支持居家護理，提供健康膳食，並為護理人員提供喘息之機，幫助成員避免更昂貴的住院或急診護理。該報告分析了其中 12 項支持措施，以評估它們對健康和成本結果的影響。研究這 14 個社區支持計畫中的 12 個，是因為它們獲得了California 1915(b) CalAIM豁免的授權， California每年都必須向聯邦政府報告該豁免情況。​​ 

DHCS submitted its annual 2024 report to the federal Centers for Medicaid & Medicare Services. It analyzes the impact of 12 Community Supports on member health care, including a new cost-effectiveness analysis for calendar year 2023. Key highlights from the report include:​​ 

• 在 2024 年，超過 494,000 個社區支持已向超過 252,000 名醫療服務會員提供。​​ 
• Twelve Medi-Cal MCPs across 23 counties now offer all 14 approved Community Supports; all MCPs statewide offer at least eight.​​ 
• 所有研究的 12 項服務都與降低成本的住院服務和/或急診部門有關。​​ 
  • 在接下來的六個月內，至少使用房屋三重社區支援服務（房屋過渡導航服務、住房存款和房屋租賃和持續服務）的成員，住院和急診部的使用量分別減少 24.3% 和 13.2%。​​ 
  • 研究對像中人數最多的醫療客製化餐/醫療支援食品與住院和急診就診率的大幅下降有關（分別下降了 21.4% 和 22.0%）。​​ 

COST-EFFECTIVE ANALYSIS: Research showed that 9 of the 12 Community Supports studied are already demonstrably cost-effective, and three are likely to be proven so over time, consistent with federal rules. Members using these services typically saw net reductions in (or offsets of) applicable service costs. Examples include:​​ 

• 房屋存款相關的是 31.6%淨成本降低。​​ 
• 日間訓練與淨成本降低 17.1% 有關。​​ 
• 冷靜中心的淨成本減少 11.7%。​​ 
• 暫停服務的相關率為 61.3%淨成本降低。​​ 
• 個人護理和家事服務與淨成本降低 58.4% 有關。​​ 

由於評估期間較短，成本效益分析可能被低估，導致直接成本完全體現，但長期節省卻未被體現。DHCS 承認，更廣泛的舉措，如加強護理管理，可能會對這些結果產生影響。隨著更多數據的出現，未來的評估可能會改進這些方法，並將根據豁免要求進行獨立評估。​​ 

IMPACT OF COMMUNITY SUPPORTS: The expansion of Community Supports has increased access in rural and underserved areas, with health plans such as Anthem Blue Cross, Health Net, and Partnership HealthPlan of California leading efforts to introduce new services in both urban and rural counties. These three plans are among the largest in the state and demonstrated significant expansion of Community Supports in 2024, both in terms of the number of new services elected and geographic spread, particularly in rural counties. As a result, Medi-Cal members in all 58 California counties now have access to a broad array of Community Supports.​​  

WHAT’S NEXT: DHCS released an updated Community Supports Policy Guide that is aligned with the Enhanced Care Management and Community Supports Action Plan. On July 1, 2025, the new Transitional Rent benefit will be optional for MCPs to offer, and will become the first mandatory Community Support on January 1, 2026.​​ 

DHCS 繼續致力擴大和加強社區支持，以更好地滿足全州 Medi-Cal 成員與健康相關的社會需求。加利福尼亞正在努力推動其歷史上的努力，通過預防、尊嚴和穩定解決全人護理，同時注意利潤。這種方法已經有所改變，尤其是在減少可避免的醫療護理使用，並改善具有多種而複雜的健康需求的會員的體驗。​​ 

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通訊辦公室​​ 
(916) 440-7660
DHCSPress@dhcs.ca.gov​​