熟練護理設施價值策略
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 為 SNF 價值策略提出了以下指導原則。這些指導原則可能會透過利害關係人參與程序作進一步修改和完善。
- 全人護理和護理協調：透過加州醫療保險管理性護理服務系統協調和整合護理，為有機構護理層級需求的會員提供全人護理，並支援全面性管理性長期服務和支援（MLTSS）的發展。
- 品質責任與獎勵：要求 SNF 負責提供高品質的住院病人照護，並鼓勵改善品質，同時減少健康差異，以符合並促進 DHCS 的全面品質策略。
- 照護轉換與財務結盟：為在適當的環境中提供照護創造財務獎勵，包括醫院、SNF 和 HCBS 環境之間的適當轉換。
- 勞動力投資與責任：強調勞動力作為高品質居民照護的關鍵驅動力的重要作用，並要求設施負責使用 Medi-Cal 資金為工人提供公平的報酬和福利。
- 財務可持續性和效率：經濟且有效率地提供服務，以支援加州醫療照護系統的財務永續性及負擔能力。
- 使用權和系統完整性：支持充分獲得專業護理設施的照護，包括在農村地區，並消除住客入院、轉院和出院時的不當獎勵。
DHCS 已選擇 Mathematica 和 Myers and Stauffer 作為顧問支持這項工作。
利害關係人參與
DHCS 正在召集利益相關者諮詢工作組，以協助制定 SNF 價值策略。參與工作小組的人士是經由公開徵求提名而選出，旨在反映 SNF 系統的複雜性和廣泛性，包括設施經營者和管理者、管理性照護計劃、設施工人和勞工代表、消費者權益維護者、有生活經驗的病患和家屬，以及長期照護臨床醫師和政策專家。
除了召集專門的工作小組外，DHCS 還將透過定期的全體成員網路研討會以及其他現有的利益相關者論壇，定期向利益相關者提供最新資訊。
公開會議
公開全員網路研討會 #1
日期：星期五, 二月20 、2026
時間：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
相關作品
長期護理補償率
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.
療養院融資改革 (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.
保持聯繫
To receive updates on the SNF Value Strategy and relate programs, sign up for the e-mail distribution list.
問題
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
請注意LTSS 融資處處長
提供商費率發展部
國會大道 1501 號，密西西比州 4600
郵政編碼 箱子九九七四十七
加利福尼亞州薩克拉門托 99-7417