-
Resource
Medi-Cal Bold Idea — Partially Unified Financing: Covered California for Most
This proposal suggests transitioning most Californians — including many currently enrolled in Medi-Cal — into Covered California plans. The model aims to create a more continuous and equitable coverage system.
-
Resource
Medi-Cal Bold Idea — Multipayer Primary Care Payment Reform Model
This proposal outlines a unified primary care payment model across Medi-Cal, CalPERS, and Covered California.
-
Resource
Medi-Cal Bold Idea — In-Home Supportive Services Integration into Managed Care
This proposal suggests integrating In-Home Supportive Services (IHSS) into Medi-Cal managed care to improve care coordination and oversight while preserving recipient self-direction.
-
Resource
Medi-Cal Bold Idea — Consideration of a Medicaid Per Capita Cap
This proposal explores a shift from open-ended federal matching funds to a per capita cap model for Medicaid, examining how this approach could offer California greater policy flexibility and budget predictability.
-
Blog
This Federal Experiment Is Pouring Money into Mental Hospitals. Will It Work?
California and other states are joining a federal pilot project that’s funneling new funding into institutional care for people with serious mental illness.
-
-
Resource
CalAIM Billing Guide for Housing-Related Community Supports Providers
This updated guide outlines the five main steps of the health care billing cycle, with detailed instructions on how homeless services providers and community organizations can approach each activity.
-
Resource
California’s County-Based Health Plans Almanac — 2024 Edition
The state’s county-based health plans are public entities organized through one or more counties to ensure that Medi-Cal enrollees, and in some cases county employees and Covered California enrollees, receive comprehensive care. Where are these plans and who do they…
-
Resource
Building on CalAIM’s Housing Supports: Strengthening Medi-Cal for People Experiencing Homelessness
This paper examines the successes, challenges, and opportunities in providing person-centered care to people experiencing homelessness. It offers seven recommendations California policymakers can take now to implement Medi-Cal housing supports and achieve person-centered care for people experiencing homelessness.
-
Resource
CalAIM Behavioral Health Payment Reform
Learn about the organization of mental health and substance use disorder services in Medi-Cal, including financing and payment, and changes to those systems under the CalAIM Behavioral Health Payment Reform initiative.
-
Resource
CalAIM and Specialty Behavioral Health Care: Lessons from Other States on Value-Based Payment
This paper summarizes existing research and profiles five examples of value-based payment models across the US. The authors provide recommendations that California can follow to inform future behavioral health payment reforms.
-
Resource
Billing Better in CalAIM
This issue brief outlines key challenges with each step of the billing process and technological and process-oriented recommendations for addressing them. Recommendations reflect potential strategies that could be implemented by the Department of Health Care Services, managed care plans, and…
-
Blog
Pioneering Study Links Higher Primary Care Spending Percentage Among Medi-Cal Managed Care Plans to Better Quality of Care and Plan Rating
Study released after the newly enacted state budget establishes the Office of Health Care Affordability to measure and promote a sustained systemwide investment in primary care, and Medi-Cal managed care will start to report primary care expenditures in 2024.
-
Resource
Medi-Cal Explained: What Are Alternative Payment Models?
This issue brief explores how Medi-Cal has been developing alternative payment models to align with federal initiatives and state financial and policy goals. It looks at the benefits of these models and barriers to their adoption.
-
Resource
Medi-Cal Explained: How Health Centers Are Paid
Learn about payment methods for community health centers and Federally Qualified Health Centers, including prospective payment system reimbursement.
