California’s Medi-Cal program is the largest Medicaid program in the nation, covering over 13 million adults and children. The program covers roughly 34 percent of California’s population, providing a unique opportunity to improve health and well-being across the state. With this goal in mind, California’s Department of Health Care Services (DHCS) launched California Advancing and Innovating Medi-Cal (CalAIM) in January 2022. This five-year initiative is transforming the delivery of Medi-Cal-covered services to ensure more equitable, coordinated, and person-centered care for Californians. CalAIM seeks to build a statewide system of care that provides a whole-person approach to care addressing enrollees physical, behavioral, social, developmental, dental, and long-term care needs.
The Center for Health Care Strategies (CHCS) is partnering with the California Health Care Foundation, DHCS, The SCAN Foundation, and other stakeholders across the state to support a variety of efforts designed to ensure the success of CalAIM. CHCS is involved in activities to design and maximize reform efforts, plan implementation, and evaluate CalAIM’s impact on providers and communities. Specific CalAIM priorities that CHCS is exploring include opportunities to:
- Strengthen community-based organizations;
- Support the delivery of enhanced care management;
- Use managed care contracts to support CalAIM goals;
- Design a DHCS community advisory board;
- Implement plan-administered institutional long-term care;
- Operationalize medical respite as an “in lieu of service;”
- Expand non-traditional providers, including community health workers and doulas;
- Build cross-sector partnerships to support people experiencing homelessness;
- Improve maternal health services access and quality;
- Integrate behavioral health services; and more.
Although much of the work is specific to the California landscape, many of the lessons can inform other states seeking to pursue more equitable, coordinated, and person-centered care, particularly for priority populations. See below for select CHCS-developed resources related to CalAIM.