CalAIM — California’s delivery system and payment reform initiative that launched in 2022 — focuses on transforming the health and well-being of California Medicaid (Medi-Cal) enrollees by enhancing population health, expanding access to whole-person care, and addressing health-related social needs.

Two key components of CalAIM are Enhanced Care Management (ECM) and Community Supports, also known as In Lieu of services. These elements of the CalAIM initiative are designed to support people with complex needs and to expand whole-person, coordinated care within the state’s Whole Person Care pilots and Health Home Program, particularly for people experiencing homelessness and individuals transitioning from incarceration.

This brief, made possible through support from the California Health Care Foundation, shares initial observations from the first months of ECM and Community Supports implementation, promising practices identified so far, and what to look for as CalAIM implementation moves forward. To develop the brief, the Center for Health Care Strategies conducted interviews with managed care plans, community-based organizations, organizations representing or providing technical assistance to Community Supports providers, and county behavioral health agencies, among other stakeholders.