ECM, HCBS, ILOS — these are just some of the program titles in California’s CalAIM initiative to restructure its delivery of Medi-Cal. What do these acronyms mean, and what will the programs accomplish?
In this video from our recent 2021 Los Angeles State of Reform Health Policy Conference, Beau Hennemann, director of special programs at Anthem, Susan Philip, deputy director of health care delivery systems at the California Department of Health Care Services, and Martha Santana-Chin, Medi-Cal president for Health Net, talk through how CalAIM’s innovative programs will transform Medi-Cal in the coming years.
Philip explained that DHCS has changed the title of its “ILOS” acronym to “Community Supports” in order to more accurately reflect the program’s goals. Community Supports provide medically appropriate services that aren’t in the State Plan for members in need of alternative services. DHCS will authorize 14 Community Supports services in its managed care contracts.
“Plan partners are encouraged to offer a really robust menu of community supports to address conditions that are caused or exacerbated by social determinants of health … The whole notion is for us to build capacity over the next few years so that we really can make sure the system as a whole has the capacity to provide these services.”
Santana Chin spoke about how health plans are preparing to implement CalAIM when it’s officially implemented in Jan. 2022. She said DHCS and the consulting firms involved have done a “phenomenal job” at planning for CalAIM and cooperating with health plans and counties.
“The implementation has required an unprecedented level of energy, cross-sector collaboration, regular and close communication, and even deeper levels of partnership between all the stakeholders … This is a really unique opportunity to address social determinants of health and help really advance health equity, so we’re very, very excited.”
Hennemann said delivery system reform has been a work-in-progress for a number of years, with programs like Long-Term Support Services (LTSS), Cal MediConnect, and “huge steps forward” like the Health Homes Program and Whole Person Care helping pave the way.
“Over the course of the last decade, it feels like this gap between the health care delivery system and managed care plan[s] and community-based organizations who are doing some of these things has slowly started to shrink.”