Preparing For CalAIM – Developing New Service Models To Capitalize On The New CalAIM Opportunities
California Advancing and Innovating Medi-Cal (CalAIM) is a long-term commitment to transform and strengthen Medi-Cal, offering Californians a more equitable, coordinated, and person-centered approach to maximizing their health and life trajectory. CalAIM’s bold mission to transform Medi-Cal will require the investment and sustained commitment of a broad network of health partners, including health plans, provider and community-based organizations with incentives to achieve a high quality of service. CalAIM is creating a better Medi-Cal for 14million Californians, offering more equitable, coordinated, and person-centered care.
In the multi-year implementation, some of the provisions of CalAIM began on January 1, 2022, which included managed care health plan contracting opportunities with provider organizations to deliver Enhanced Case Management and Community Supports (In Lieu of Services) for adult SMI populations. The final provisions are projected to go live by 2027.
One big question for executives of specialty provider and primary care organizations is how to develop the ‘next generation’ of services that will be in high demand under CalAIM. These new service models will likely require integrated approaches, be delivered using hybrid service systems, and have reimbursement based on some measure of performance. To accomplish this, executive teams will need to adopt new models for assessing market opportunities, develop new service lines under alternative payment approaches (VBR), and optimize current service delivery performance. This session will cover:
- Emerging service line opportunities under CalAIM and how to assess them.
- A best practice service line feasibility analysis and development process.
- Innovative Programming: Leveraging hybrid models of care for cost effective service delivery.
- A panel discussion of specialty care and primary care provider organization executives on their new service line development planning, roll out of Enhanced Care Management (ECM) and Community Support (CS) services and partnership with Medi-Cal managed care plans.