CalAIM (California Advancing and Innovating Medi-Cal) is a multiyear care delivery and payment reform initiative led by the California Department of Health Care Services (DHCS). CalAIM focuses on improving health equity and quality of care and well-being for California Medicaid (Medi-Cal) enrollees by enhancing population health; expanding access to coordinated, whole-person care; and addressing health-related social needs.

Launched in 2022 and rolling out over multiple years, two key components of CalAIM are Enhanced Care Management (ECM) and Community Supports (also known as In Lieu of Services). DHCS designed these two initiatives to support people with complex health and social needs and to sustain and expand person-centered, whole-person care coordination in the state’s Whole Person Care pilots and Health Home Program, especially for those experiencing homelessness and those transitioning from incarceration.

This brief shares 10 observations from the first months of Community Supports and ECM implementation, some opportunities related to promising practices, and what to watch in the coming months as CalAIM implementation moves forward. To develop this brief, the Center for Health Care Strategies (CHCS) conducted 13 interviews from January 2022 to April 2022, including with plans; a plan association; community-based organizations; organizations representing or providing technical assistance to Community Supports providers, including Meals, Medical Respite, and Asthma Remediation providers; a Federally Qualified Health Center; and county behavioral health agencies. In addition, CHCS reviewed notes from seven managed care plan interviews conducted by ATI Advisory.

About the Authors

This paper was prepared by Diana Crumley, JD, MPAff; Kelsey Brykman, MS; and Matthew Ralls, MPH, at the Center for Health Care Strategies. The Center for Health Care Strategies is a national policy design and implementation partner devoted to improving outcomes for people enrolled in Medicaid.