Early data of California’s CalAIM benefits show improvements in stabilization


Hannah Saunders


California Advancing and Innovating Medi-Cal (CalAIM), a long-term commitment to transform and strengthen Medi-Cal, has seen promising data results for its Enhanced Care Management (ECM) and Community Supports (CS) benefits.

Early DHCS data shows that initial enrollment in ECM and CS were primarily from members who were transitioning from the Whole Person Care (WPC) pilot and Health Home Program (HHP). For both services, the number of transitioned members receiving services declined by Q2—when many members stabilized and no longer needed services. The number of new members receiving benefits increased simultaneously.


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ECM is a statewide Medi-Cal benefit available to the highest-need enrollees to address clinical and non-clinical needs through intensive coordination of health and health-related services. Populations of focus include:

  • Individuals and families experiencing homelessness
  • Adults, youth, and children who are high utilizers of avoidable emergency department, hospital or short-term skilled nursing facility services
  • Adults with serious mental illness or substance use disorder
  • Children and youth with a serious emotional disturbance, identified to be at high risk for psychosis or experiencing a first episode of psychosis
  • Adults and youth who are incarcerated and transitioning to the community
  • Adults at risk of institutionalization and eligible for long term care
  • Adult nursing facility residents transitioning to the community
  • Children and youth enrolled in California Children’s Services (CCS) with additional needs beyond CCS
  • Children and youth involved in child welfare, including those with a history of involvement in welfare, and foster care up to age 26

According to the Department of Health Care Services (DHCS), over half of Medi-Cal spending is attributed to the 5% of enrollees with the highest-cost needs, and Medi-Cal enrollees generally have several complex health conditions involving physical, behavioral, and social needs. Enrollees with complex needs must frequently engage in several delivery systems to access care, including primary and specialty care, dental, mental health, substance use disorder, and long term services and support.

ECM early data

ECM has a phased implementation that launched on January 1st, 2022, for select populations of focus in the 25 WPC and HHP counties. ECM and CS are building upon the work of these programs. By July 1st, ECM was launched in the remaining counties for select populations of focus. 

In Q2 of 2022, there were 674 ECM providers, and 68,399 total enrollees. The cumulative enrollment of populations of focus for Q1 and Q2 of 2022 was:

  • Adults who are high utilizers of avoidable healthcare visits: 34,000
  • Adults with serious mental illness or substance abuse disorder: 26,000
  • Adults experiencing homelessness: 19,000
  • Adults transitioning from incarceration: 3,000

In Q2, 56% of those who utilized ECM identify as female, while 44% identify as male. Regarding race and ethnicity, 40% are Hispanic, 22% are Black or African American, 20% are white, 8% are “Other”, 5% are Asian or Pacific Islander, 4% are unknown, and less than 1% are American Indian or Alaska Native. 

Community Supports

Managed care plans also launched CS in 2022 as cost-effective alternatives to traditional medical services and settings. CS is designed to address social drivers of health, and all Medi-Cal MCPs are encouraged to offer as many of the 14 pre-approved supports as possible:

  • Housing transition navigation services
  • Housing deposits
  • Housing tenancy and sustaining services
  • Short-term post-hospitalization housing
  • Recuperative care
  • Day habilitation programs
  • Caregiver respite programs
  • Nursing facility transition and diversion to assisted living facilities
  • Community transition services and nursing facility transition to a home
  • Personal care and homemaker services
  • Environmental accessibility adaptations, such as home modifications
  • Medically supportive food and meals
  • Sobering centers
  • Asthma remediation

As of July 1st, 2022, all MCPs offered at least one CS service, while 24 MCPs offered four or more services. Medi-Cal MCPs may increase or change services offered every six months, according to DHCS.

In the first half of 2022, 21,595 members received at least one CS, although that number is expected to grow as more providers contract with MCPs to deliver services and develop their capacity.

The top four CS services provided in Q2 of 2022 were housing tenancy and sustaining services (6,000 individuals), housing transition and navigation services (5,000 individuals), medically-supportive food and medically tailored meals (1,000 individuals), and recuperative care (1,000 individuals).

From Q1 to Q2, the number of members from HHP grew from 1,013 to 1,163. Members from WPC decreased from 12,659 to 6,601. The number of new members grew from 2,885 to 5,545. 

While early data shows promising results for these benefits, subsequent reforms will be phased in through 2027. This month, ECM services became available for select populations of focus in all counties. In July, ECM services will be available to all children and youth who are populations of focus.