CalAIM Programs

What is California Advancing and Innovating Medi-Cal (CalAIM)?

California Advancing and Innovating Medi-Cal (CalAIM) is a multi-year initiative and commitment led.by the California Department of Health Care Services (DHCS) to improve the quality of life and health outcomes of Medi-Cal members and transform and strengthen Medi-Cal. Offering Californians a more equitable, coordinated, and person-centered approach to maximizing their health and life trajectory through broad delivery system, program and payment reform across the Medi-Cal program. DHCS is innovating and transforming the Medi-Cal delivery system. CalAIM is moving Medi-Cal towards a population health approach that prioritizes prevention and whole person care. Our goal is to extend supports and services beyond hospitals and health care settings directly into California communities.

• DHCS Medi-Cal Transformation

ECM (Enhanced Care Management)

Enhanced Care Management is person-centered care management provided to the highest-need Medi-Cal enrollees, primarily through in-person engagement where enrollees live, seek care, and choose to access services.

• DHCS Enhanced Care Management Policy Guide
• ECM Populations of Focus (POF) Eligibility

Community Supports (also known as “In Lieu of Services”)

Medi-Cal managed care plan partners will begin offering “Community Supports,” such as housing supports and medically tailored meals, which will play a fundamental role in meeting enrollees’ needs for heath and health-related services that address social drivers of health.

• DHCS Community Supports Policy Guide
• CalAIM Community Supports Fact Sheet
• Medically Tailored Meals (MTM) Provider Info

Long-Term Care Carve-In Transition

Under CalAIM, Medi-Cal managed care plans (MCPs) will cover and coordinate Medi-Cal institutional Long-Term Care (LTC) in all counties in 2023 in a phased approach by facility type. This will provide all LTC residents with access to coordinated and integrated care within Medi-Cal managed care and make coverage consistent across California. The goal of the Medi-Cal LTC carve-in is to better integrate care across institutional and home- and community-based settings as well as to make the LTC delivery system consistent across all counties in California. MCPs can offer complete care management, and provide a broader array of services, including Enhanced Care Management and Community Supports.

• Skilled Nursing Facility Overview
• Medi-Cal Long Term Care Carve-In
• DHCS LTC Accommodation to Revenue Code Crosswalk
•  DHCS Long-Term Care (LTC) Carve-In Transition

If you have additional questions about CalAIM, please email us at CCHPCalAIM@cchealth.org

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