Preparing For CalAIM – Innovative Best Practices Serving Complex Adults & Youth
California Advancing and Innovating Medi-Cal (CalAIM) is a long-term commitment to transform and strengthen CA Medicaid (Medi-Cal), offering 14M+ beneficiaries a more equitable, coordinated, and person-centered approach to maximizing their health.
The California Department of Health Care Services (DHCS) is transforming the Medi-Cal delivery system moving Medi-Cal towards a population health approach that prioritizes prevention and whole person care. CalAIM will offer Medi-Cal enrollees coordinated and equitable access to services that address physical, behavioral, developmental, dental, and long-term care needs. In the multi-year implementation, some provisions went live in 2022, including new managed care plan contracts with specialty provider organizations/CBOs to deliver Enhanced Care Management and Community Support services for adults with severe mental illness. Similar contracts will begin in 2023 for youth (SED), and the final provisions of CalAIM are projected to go live by 2027.
As populations eligible for services continue to expand under CalAIM in 2023, so do the opportunities for provider organizations to grow new services for new populations, i.e., children and adolescents. The question for specialty care and primary care organization executives is how to develop a sustainable strategy for new service delivery, evidence-based practices, service process management, and new reimbursement approaches.
The session will cover:
- Overview of expanding populations of focus under CalAIM
- Best practice approaches for service line development using evidence-based practices
- Keys to successful service process management and coordinated client care
- Strategies for sustainability in the competitive California Medicaid landscape