Key Takeaways
- California’s Medi-Cal Community Care Hubs landscape is evolving, providing an opportunity to streamline support to community-based health care providers that are newer to contracting with managed care plans.
- There is concern about funding and additional complexity for some community-based providers in working with Medi-Cal Community Care Hubs, and whether Medi-Cal members’ quality of care and health outcomes will be improved.
- Challenges are particularly prevalent in rural regions and among small providers where there is a low volume of members eligible for services.
Medi-Cal community care hubs are emerging as critical components in California’s health care landscape, particularly in the context of recent CalAIM (California Advancing and Innovating Medi-Cal) initiatives. These hubs have gained relevance due to their role in facilitating the integration of physical health, behavioral health, and health-related social needs through programs such as Enhanced Care Management and Community Supports.
These hubs also support a range of benefits beyond CalAIM, including community health worker and doula services.
This report, developed by Aurrera Health Group, provides an overview of the landscape of hubs throughout California, many of which are participating in Medi-Cal’s Enhanced Care Management and Community Supports through CalAIM, providing Medi-Cal community health worker or doula services, or both.
Readers will learn:
- Challenges and potential solutions for implementing Enhanced Care Management and Community Supports in CalAIM. Understanding these issues is crucial for ensuring the success of this multiyear effort to improve care for Medi-Cal’s most vulnerable populations.
- Barriers faced by new and existing providers in navigating the Medi-Cal managed care billing process. This information can help identify and remove obstacles that may hinder the expansion and diversification of the provider network.
- Opportunities for technological and administrative improvements.
Infrastructure and operational changes among the California Department of Health Care Services, managed care plans, and providers can guide improvements in the overall delivery system.
This landscape report and interviews with health plan representatives, county providers, community-based organizations, and associations show there are opportunities for health and policy leaders to provide policy clarification, technical assistance, and other supports to advance thoughtfully designed and wider implementation of Medi-Cal community care hubs.
