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Santa Clara Family Health Plan Introduces Cal MediConnect – A Program to Serve People in Santa Clara County who are Eligible for both Medicare and Medi-Cal

Corporate news | Tuesday, January 6, 2015

Campbell, CA – January 6, 2014 – Santa Clara Family Health Plan (SCFHP) announced today a new health plan option for Santa Clara County low-income seniors and people with disabilities who have both Medicare and Medi-Cal. On January 1, SCFHP welcomed more than 5,500 new members to its Cal MediConnect Plan. This important program coordinates long-term services and supports with Medicare and Medi-Cal benefits to ensure members with complex medical needs receive proper care in the right setting and support to remain in the community.

Cal MediConnect is part of California's larger demonstration plan known as the Coordinated Care Initiative (CCI), which transforms the delivery of health care for seniors and people with disabilities. People eligible for both Medicare and Medi-Cal, called dual eligibles, often manage a multitude of health conditions, medications, and providers, and must navigate the rules and processes of two separate healthcare delivery systems. Cal MediConnect integrates dual eligibles' care across all their entitlement benefits from Medicare, Medi-Cal, and other supportive services. Essentially, the program combines and coordinates medical care, social services supports, and long-term and community-based care under one managed care plan.

"SCFHP's Cal MediConnect Plan is an innovative way for dual eligible beneficiaries in Santa Clara County to receive their health care and social services supports. This demonstration plan, as envisioned by the State, Federal, and health plan partnership, is intended to improve outcomes and quality of life for plan members, ensure more community-based services and supports, and work to prevent or greatly delay institutionalized care," said SCFHP CEO Elizabeth Darrow.

Cal MediConnect Plan members receive a number of added benefits at no cost, including vision care, transportation to medical appointments, and the support of a case manager and care team. Case management and care coordination together are the linchpins of the Cal MediConnect program.

Following a rigorous application process and readiness review, SCFHP was selected by the California Department of Health Care Services and Centers for Medicare and Medicaid Services as a partner in the CCI Cal MediConnect three-year demonstration project.

"SCFHP has worked closely with providers, community partners, and stakeholders to build a health plan that will provide better coordinated care for dual eligibles," said Tony Solem, SCFHP Chief Medicare Officer. "We extend our warmest welcome to SCFHP Cal MediConnect members and look forward to being an important partner in their health care.