DHCS releases revised CalAIM proposal

The California Department of Health Care Services (DHCS) released an updated CalAIM proposal last week, introducing key changes following stakeholder feedback and adjustments due to the COVID-19 pandemic.

The CalAIM initiative aims to implement broad program, delivery system, and payment reform for the Medi-Cal program. The initiatives three primary goals focus on addressing social determinants of health and adopting whole person care approaches, reduce Medi-Cal complexity while increasing flexibility, and improving outcomes and driving delivery system transformation.

 

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DHCS originally released the CalAIM proposal in October 2019, after which the agency conducted extensive stakeholder meetings. The department then postponed implementation of the CalAIM initiative, originally scheduled for January 2021, to focus on the public health emergency. The new start date is slated for January 1, 2022.

With the new proposal, DHCS also released a document highlighting major changes made to the initiative since it was first released in 2019.

Adjustments to implementation timelines were a common change throughout the new proposal. For example, the new statewide enhanced care management benefit will be implemented through a phased in approach. Medi-Cal managed care plans in counties with Whole Person Care (WPC) pilots or Health Homes Programs (HHP) will transition high-need beneficiaries on January 1, 2022. In counties without WPC or HHP, managed care plans will have until July 2022 to begin implementation.

The new proposal also reflects an increased focus on collaborating with communities. Under the proposal, Medi-Cal managed care plans will need to maintain a person-centered population health management strategy. The new proposal adds the requirement that plans “must partner with community-based providers to address members’ needs.” It also offers a clarification that these strategies “should be developed in coordination with both county behavioral health and public health departments.”

A rundown of all changes made to the proposal are available here.

DHCS will host a CalAIM relaunching webinar on January 28, 2021, from 2-3pm. The department will review the new proposal and key changes made.