Meeting the Moment: Strengthening Managed Care’s Capacity to Serve California’s Seniors and Persons with Disabilities
California’s two million Medi-Cal Seniors and Persons with Disabilities (SPDs) can face significant challenges getting the medical and long-term services and supports they need. Reform elements in the California Advancing and Innovating Medi-Cal (CalAIM) initiative have the potential to increase system integration and coordination of care for those SPDs with Medi-Cal only and those that qualify for Medicare and Medi-Cal (dually eligible enrollees).
This issue brief from the Center for Health Care Strategies (CHCS) and Chapman Consulting builds on interviews with representatives of Medi-Cal managed care plans and additional stakeholders to highlight challenges and opportunities regarding implementation of the proposed reforms. It also identifies key success factors for care innovation and integration, and opportunities to advance capacity for an integrated system of medical and long-term services and supports for all SPDs.
Several of the reforms outlined in CalAIM are expected to improve care for dually eligible enrollees and other SPDs. The figure below highlights the timing of key implementation milestones for those reforms.
To build on this issue brief, in partnership with CHCS and Chapman Consulting, CHCF sponsored a webinar on May 11, 2021: “Looking Forward: Examining Long-Term Services and Supports Integration and Opportunities to Strengthen Coordination Under CalAIM.” Webinar panelists, including long-term services and supports (LTSS) and Medi-Cal managed care plan (MCP) representatives, discussed experiences developing partnerships and described lessons around developing MCP and LTSS partnerships, addressing barriers and leveraging opportunities to expand access to home- and community-based services, and elevating strategies to support data sharing and improve care coordination.
About the Authors
Giselle Torralba, MPH, is a program associate and Alexandra Kruse, MS, MHA, is the associate director for integrated care, state programs at the Center for Health Care Strategies, a national nonprofit policy center dedicated to improving the health of Americans with low incomes, including those dually eligible for Medicare and Medicaid and in need of Medicaid long-term services and supports. Athena Chapman, MPP, is president and Elizabeth Evenson is policy director at Chapman Consulting, which provides strategic planning, meeting facilitation, organizational support, market research, and regulatory and statutory analysis to organizations in the health care field.