By Trish Violett, Junior Policy Consultant and Megan Thomas, Director, Quality Initiatives

Over the past four years, the 52 hospitals and health systems participating in the California Public Hospital Redesign and Incentives in Medi-Cal (PRIME) program have been working to improve care delivery and maximize health care value through a “pay-for-performance” model. The PRIME hospitals are using evidence-based quality improvement methods to achieve designated goals and outcomes on select clinical projects and associated performance metrics.

By Lilly Clements, Junior Policy Consultant and Megan Thomas, Associate Director

Since 2014, the Cal MediConnect (CMC) program has coordinated care for some of the most vulnerable Californians. CMC was developed by the Department of Health Care Services (DHCS) and the Centers for Medicare & Medicaid Services (CMS) to better serve dual eligible beneficiaries – those enrolled in both Medicare and Medi-Cal (Medicaid in California).

A primary focus of CMC is to better coordinate behavioral health care service delivery for members. This week, DHCS released a report entitled “Improving Behavioral Health Integration and Coordination for Cal MediConnect (CMC) Members,” which details the complexities and nuances of CMC plans’ efforts to integrate behavioral health into the care delivery system for dual eligible beneficiaries.