CCI Comprehensive Strategy Update

Earlier this year, the Department of Health Care Services (DHCS) shared for stakeholder comment a comprehensive strategy for the Coordinated Care Initiative (CCI).  This strategy focused on improving the quality of care and care coordination beneficiaries receive through Cal MediConnect, ensuring that beneficiary satisfaction remains high and increases, and generating sustainability for the program.  After considerable feedback from stakeholders, DHCS announced final policy decisions in May.  Today, DHCS is sharing an update on these policy decisions, as well as an additional document for stakeholder comment.

Voluntary Enrollment Strategy

DHCS announced its intent to pursue a robust voluntary “opt-in” enrollment effort for the remainder of 2016.  Today, DHCS is releasing its DRAFT Cal MediConnect Voluntary Enrollment Strategy for stakeholder comment.  It is available here.

This strategy, designed to expand awareness of Cal MediConnect and encourage voluntary enrollment, builds on activities DHCS and its partners are already conducting.  This strategy also incorporates many of the lessons learned about how best to reach and educate beneficiaries and providers about the CCI and Cal MediConnect.  These strategies include streamlined enrollment and mandatory Medi-Cal plan enrollment for managed long-term services and supports (MLTSS).

DHCS is soliciting feedback from stakeholders on the activities included in this strategy, as well as additional activities Cal MediConnect partners can pursue.  Feedback is due Thursday, July 14, 2016.

Standardized LTSS HRA Questions & Data Measures

DHCS announced that it would strengthen LTSS referrals and improve care coordination by standardizing the Health Risk Assessment (HRA) referral questions for LTSS to reflect the best practices developed over the early years of the program and expanding data collection and reporting.

DHCS released draft HRA referral questions in June and received valuable stakeholder feedback. In response to that feedback, and given the importance of selecting the most effective questions, DHCS will convene a small workgroup in order to identify and agree on a final list of questions that will best meet the needs of beneficiaries.

DHCS appreciates the feedback it received on the draft revised data measures and will share final measures later this month.

Provider Opt Out Data

DHCS has shared with Cal MediConnect health plans the detailed analysis of beneficiaries who have opted out of the program, and their most frequently used providers, in order to more effectively focus provider education and outreach activities.  We have begun discussions with the plans on opportunities for partnership on education and outreach activities.

Best Practices Meetings

DHCS held the first in a series of meetings with Cal MediConnect plans to share best practices and ensure all plans are performing to the highest standard.  Moving forward, DHCS will convene these meetings regularly.  DHCS is asking that stakeholders submit topics for consideration at future meetings to info@calduals.org on an ongoing basis.

Continuity of Care

DHCS announced that it would extend the continuity of care period for Medicare services from six months to 12 months to match the Medi-Cal continuity of care period, and modify requirements to just one visit with a specialist within the past 12 months, as is the case with primary care physicians.  DHCS is working with CMS and Cal MediConnect plans to update its Dual Plan Letter and prepare for implementation in late Fall 2016.

Streamlined Enrollment

Streamlined enrollment will provide a simpler method for beneficiaries to enroll in the Cal MediConnect product associated with their existing MLTSS plan.  DHCS has begun operational testing with the plans and will begin streamlined enrollment later this summer, with formal notification of the official start date to come.

MLTSS Enrollment

The new Cal MediConnect and MLTSS Resource Guide and Choice Book has gone through the University of California’s beneficiary user testing process and is being finalized.  DHCS anticipates ongoing mandatory enrollment of MLTSS-eligible beneficiaries into MLTSS plans will begin in Fall 2016.  The final Resource Guide and Choice Book will be made available on CalDuals.org.

Beneficiary Took Kit

The Cal MediConnect Beneficiary Toolkit has gone through the University of California’s beneficiary user testing process and a final version will be posted on CalDuals.org by the end of July.

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Stakeholder engagement and input is critical to the success of the CCI.  All stakeholder feedback on the voluntary enrollment strategy is due by Thursday, July 14, 2016.  DHCS is requesting all questions and comments be sent to info@calduals.org.  DHCS is committed to transparency and will share additional materials for stakeholder input as they become available.

Thank you for your continued support of the CCI.