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.
Enhanced Care Management (ECM)
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.
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