California Advancing and Innovating Medi-Cal (CalAIM)

 

At the Alliance, we are dedicated to improving the health and quality of life for all in our community. We are working with our community partners to prepare for CalAIM in Alameda County.

CalAIM is a statewide California Department of Health Care Services (DHCS) multi-year initiative that builds upon the Whole Person Care (WPC), Health Home Program (HHP), and Coordinated Care Initiative (CCI) pilot programs, and is designed to implement a broad delivery system, program, and payment reform across the Medi-Cal program with the ultimate long-term goal of a better quality of life for all Medi-Cal members.

DHCS has indicated it will update information related to CalAIM as new or revised information is available.  Please check back periodically to insure you are viewing the latest information available from DHCS.

January 1, 2022, is the proposed start date for CalAIM Enhanced Care Management (ECM), In Lieu of Services (ILOS), and Major Organ Transplants (MOT). To learn more about the DHCS CalAIM program and to see the most recent updates, please click here.

 

Enhanced Care Management (ECM) and In Lieu of Services (ILOS)

One of the first of many initiatives in this multi-year program is the implementation of the ECM benefit and the ILOS services.  ECM will target seven specific populations of vulnerable and high-risk children and adults.  ILOS includes fourteen (14) voluntary options, including housing-related services and flexible wraparound services so health plans may avoid costlier alternatives to hospitalization, skilled nursing facility admission and/or discharge delay.  The Alliance is currently holding listening sessions with various community partners to understand their current and future capacity and capabilities to provide ECM and ILOS services.

Alliance members who are enrolled in the current Whole Person Care (WPC) and Health Homes Program (HHP) in December 2021 will transition into ECM on January 1, 2022.  The WPC and HHP programs will sunset on December 31, 2021.

Major Organ Transplants

As a part of the CalAIM initiative, all major organ transplants, which are currently not within the scope of many Medi-Cal Managed Care Plans (MCPs), will become the responsibility for all MCPs statewide for all adult Medi-Cal members enrolled in a plan.  This change is effective January 1, 2022.

Proposed CalAIM Timelines*

Key Updates and Resources

Alliance CalAIM Listening Sessions

The Alliance will be hosting Virtual Alliance/Anthem CalAIM Enhanced Care Management (ECM) & In Lieu of Services (ILOS) Community Listening Sessions. The first listening session has been rescheduled to Friday, July 16, 2021, from 3 pm – 4:30 pm. The Thursday, May 20, and Wednesday, May 26, listening sessions have been canceled. Please see the registration information below.

Alliance/Anthem CalAIM Enhanced Care Management (ECM) & In Lieu of Services (ILOS) Community Listening Session #1

Community Listening Session #1 will be held on Friday, July 16, 2021, from 3 pm to 4:30 pm. To register for this listening session, please click here.

Alliance CalAIM Entity Interest Form

To sign-up to receive additional information and updates, please complete the Alliance Entity Interest Form below.

Alliance Entity Interest Form