MEDI-CAL 社區支持者正在實現他們的承諾：滿足會員需求並降低成本​​ 

SACRAMENTO — The California Department of Health Care Services (DHCS) today announced the availability of data showing that Medi-Cal Community Supports are successful and cost-effective. The data show that Community Supports are delivering on their promise to address Medi-Cal member needs—reducing avoidable emergency department visits, hospital stays, and long-term care use while showing strong early signs of cost savings. All 12 Community Supports studied are reducing costs, and of these, nine have already demonstrated cost-effectiveness within the initial study period. The remaining three are projected to reach that threshold over a longer study period, consistent with federal rules for evaluating cost-effectiveness.​​ 

“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.​​ 

WHY THIS MATTERS: Medi-Cal currently offers 14 Community Supports. These services promote housing stability, ease transitions from institutional settings, support in-home care, provide healthy meals, and offer caregiver relief, helping members avoid costlier hospital or emergency care. The report analyzed 12 of these supports to assess their impact on health and cost outcomes. These 12 out of 14 Community Supports were studied because they are authorized under California’s 1915(b) CalAIM waiver, which California is required to report on each year to the federal government.​​ 

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。​​ 
• 23 個縣的 12 個 Medi-Cal MCP 現在提供所有 14 個批准的社區支持；全州的所有 MCP 至少提供八個。​​ 
• 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%。​​ 
  • 醫療量身定制的餐點/醫療支持食物是研究成員人數最多的，住院病人和急診部使用量大幅減少（分別為 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。​​ 
• Personal Care and Homemaker Services were associated with a 58.4% net cost reduction.​​ 

The cost-effectiveness analysis may be understated due to the short evaluation period, resulting in immediate costs being fully captured but not longer-term savings. DHCS acknowledges that broader initiatives, like Enhanced Care Management, may influence these results. Future evaluations may refine these methods as more data become available, and an independent evaluation will be conducted in line with waiver requirements.​​ 

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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