Streamlined Enrollment to Begin for Cal MediConnect

The Department of Health Care Services (DHCS) will begin streamlined enrollment the week of August 22, 2016, for Cal MediConnect as part of the Coordinated Care Initiative (CCI).

Streamlined enrollment allows Cal MediConnect health plans to submit enrollment changes to DHCS on behalf of their members. This will provide a simpler method for beneficiaries to enroll in the Cal MediConnect product associated with their Medi-Cal managed long-term services and supports (MLTSS) health plan as they will no longer have to take the extra step to contact the state enrollment broker, Health Care Options (HCO), to complete their enrollment choice.

Providing streamlined enrollment is part of DHCS’s comprehensive strategy for improving the CCI and Cal MediConnect program. This comprehensive strategy focuses on improving the quality of care and care coordination beneficiaries receive through Cal MediConnect, ensuring that beneficiary satisfaction remains high and the program remains sustainable.

Streamlined enrollment builds on lessons learned about effective beneficiary outreach, including that the best way to educate beneficiaries is through one-on-one conversations that answer their specific questions about their providers and the program and how to make a smooth transition. It will also be a beneficiary-friendly enrollment procedure, eliminating an extra step for beneficiaries to take to have their enrollment choice effected.

DHCS has safeguards in place to protect beneficiaries. Safeguards include HCO and the health plan both contacting the beneficiary to confirm their choice. Stakeholders have provided feedback on call scripts to ensure they are straightforward and understandable. Beneficiaries will still have the right to change their plan or disenroll from Cal MediConnect. HCO will continue to be a resource for beneficiaries to ask questions and effect enrollment changes. DHCS will continue to closely monitor this process and work with the plans to ensure the process is smooth and beneficiary protections are working.

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