Health Plan of San Mateo – Community Care Settings Pilot

The Coordinated Care Initiative, including Cal MediConnect, is a historic undertaking to help improve the lives of low-income seniors and people with disabilities in California by better coordinating their care and services.  One of the key goals of Cal MediConnect is to ensure beneficiaries have access to all the services they need to live independently.

Under the CCI, Cal MediConnect health plans are finding creative new ways to better meet the needs of the dual-eligible beneficiaries they serve.  One such promising pilot is in San Mateo County.

The Community Care Settings Pilot (CCSP) is Health Plan San Mateo’s (HPSM) highest intensity care management program for beneficiaries in institutions or at risk for institutionalization who can, with appropriate supports, live in the community successfully. The pilot utilizes unique features for these beneficiaries, focusing on deploying services that are necessary to migrate out of, or avoid placement in, long-term care facilities. The pilot is operated in partnership with two community-based organizations and leverages a number of state and local resources to support their operations.

Details of the program’s target beneficiaries, case management phases, and housing strategy can be found in this PowerPoint presentation. Early results of the program show decreased cost and overall improvement in the system – including better outcomes for their patients. As HPSM moves into the second phase of the program, they look to expand CCSP even further.

This is just one example of the way in which the CCI is helping our state move toward higher quality, more coordinated care for Californians served by our public programs.

If you have stories about individuals or programs that showcase the benefits and success of coordinated care, please email us at info@calduals.org so that we can feature their work.