The market for services to support independent living in the community is large and growing fast as baby boomers age. The California Department of Finance estimates that the state’s population age 65 and older will nearly double by 2060, reaching 11 million. Many older Californians will need help to live independently, and more than 20% of Medicare enrollees will rely on Medi-Cal to pay for services to age in place. This figure increases dramatically for people of color, as 55% of Latino/x, 41% of Asian, and 34% of Black Medicare enrollees are also eligible for Medi-Cal.

In 2022, California launched CalAIM (California Advancing and Innovating Medi-Cal), and Medi-Cal started reimbursing and incentivizing managed care plans to offer a range of services known as Community Supports that can help people live at home or in the community. These include personal care services provided in the home or an assisted living facility, transition services to assisted living or the home, home modifications such as shower bars and ramps, caregiver respite, and home-delivered meals.

The authors surveyed the current landscape of organizations to help plans navigate the emerging market for Community Supports. They interviewed 10 organizations to identify those who could provide services that meet the needs of both members and Medi-Cal managed care plans. The analysis considers a range of large regional nonprofit organizations, smaller venture-backed companies, and a few organizations that provide adjacent or enabling services.

The report also reviews the needs of managed care plans and highlights factors they consider critical to build their networks. The expansion of Community Supports opens attractive markets for entrepreneurs well-positioned to help plans fill gaps in their capacity and to help patients address their complex health needs.

About the Authors

David Ramirez, MD, is the chief medical officer of the AltaMed Health Network. He previously held leadership positions at CalOptima Health, CareMore Health, and the Seton Family of Hospitals. Tanya Shah is a health care leader with 25+ years of government, private, and nonprofit experience. She spent a decade in strategy consulting helping health care organizations commercialize high-revenue products and services. She spent the last several years implementing large-scale public health programs and identifying clinical innovation and policy levers for vulnerable and complex populations.