5 Slides: Lessons learned through CalAIM implementation

On Wednesday, 3 experts from different silos across California’s health care landscape came together at State of Reform’s “5 Slides We’re Discussing” virtual conversation to discuss the lessons they’ve learned so far as implementation of the statewide CalAIM initiative continues.

 

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Our virtual conversation featured Martha Santana-Chin, Medi-Cal President at Health Net, Katherine Bailey, CEO at the San Diego Wellness Collaborative, and Robert Jones, Founder & CEO at Roots Food Group. The conversation was hosted by State of Reform’s Vern Smith, Ph.D.

Santana-Chin showcased Health Net’s model for implementing CalAIM Community Supports. Health Net has implemented Community Supports across all 31 counties in which they operate, and she emphasized that this implementation has involved strategies largely centered around health equity, local engagement, and local investments and partnerships. 

“[Community Support services] are really important because many of the individuals that are being served by the Medi-Cal program today have a higher degree of disparities simply because they have higher social risk factors,” Santana-Chin said. 

“We know that health equity starts at the community level and is best delivered locally, so we’ve partnered with local organizations to build a robust and responsive provider network that integrates non-traditional Medi-Cal providers into the state’s Medi-Cal safety net. We’ve invested over $100 million in over 500 community-based organizations, and these investments over the years have really allowed organizations to pilot and advance promising ideas that are now really the foundation of [CalAIM’s Community Supports].”

Santana-Chin also discussed Health Net’s best practices for effective implementation of Community Supports. She emphasized the need for extensive collaboration with plan partners and providers, operational support and funding for local providers, and timely and complete data sharing.

Bailey showed some of the key learnings from the San Diego Wellness Collaborative’s first 9 months of CalAIM implementation. She said the collaborative has been leveraging the strengths of community-based organizations in San Diego County to deliver CalAIM’s Enhanced Care Management and Community Supports benefits at the grassroots level. 

She commented on some of the challenges she has noticed during the first phase of CalAIM implementation, particularly with partnerships between managed care plans and community-based organizations.

“These are in a lot of ways new partnerships,” Bailey said. “While many CBOs had community engagement-type relationships with the health plans, they didn’t have contractual and business relationships. These are really new ways of working together, and we just have to realize that new ways of working together take time.”

The fourth slide, presented by Jones, discussed the potential benefits of the CalAIM Medically-Tailored Meals Program, a partner of Roots Food Group. Jones noted that the 3-year DHCS pilot program for medically-tailored meals resulted in 32% in net health care cost savings, a 63% reduction in hospitalizations, a 50% increase in medication adherence, and a 23% increase in the likelihood of hospital discharges.

Jones emphasized the importance of food security in addressing the social determinants of health.

“So many chronic diseases are food-borne, and [these diseases] make up 80-90% of the total costs of health care,” he said. “You eat the right foods, you can put type II diabetes into remission. You get healthy very quickly.”

View the full conversation here.