The California Advancing and Innovating Medi-Cal (CalAIM) initiative will implement broad reforms to California’s Medicaid delivery system, programs, and payment methodologies. The policy goals of CalAIM are to reduce system complexity, increase flexibility, improve quality of care, and drive system transformation through value-based initiatives, payment reform, and integrated approaches for behavioral health, addiction treatment, and primary care for complex populations. In the multi-year implementation, some of the provisions go live on January 1, 2022, including new contracts with specialty provider organizations to deliver Enhanced Case Management and Community Supports (In Lieu of Services) for adult SMI populations. The final provisions are projected to go live by 2027.
One big question for specialty and primary care organizations executives is how to enhance their current tech infrastructure for success under CalAIM. There are new challenges created by the expectations of services that coordinate consumer services across levels of care – using digital tools for care coordination and service delivery. Additionally, new reimbursement models create another level of complexity. The session will cover:
- The likely requirements for integrated care coordination under CalAIM
- The technology functionality required to participate in integrated care, offer digital services, and accept value-based reimbursement under CalAIM
- A panel discussion of executives from California specialty provider organizations on their plans for technology investment and current use of technology to deliver services under CalAIM.