Medi-Cal Managed Care

Improving Behavioral Health Systems Through Operational Integration: Efforts in San Mateo County

Behavioral Health

In San Mateo County, the Medi-Cal managed care plan and the behavioral health plan are working together to streamline operational functions to better manage resources and improve member care.

California Spent Millions to Boost COVID-19 Vaccination Rates of Medi-Cal Members — But They Lag Even More

Medi-Cal, Homelessness & Health Care

Gaps in COVID-19 vaccination rates among the state’s Medi-Cal population persist. Five Medi-Cal plans still have vaccination rates under 50%.

CalAIM for Seniors and People with Disabilities

CalAIM, a multiyear initiative to transform the Medi-Cal program, includes a special focus on improving care for seniors and people with disabilities. To make the most of CalAIM, this series elevates experiences and lessons learned from past efforts to integrate and improve care for seniors and people with disabilities in California and other states.

Webinar — Opportunities for CalAIM to Support Community Living

Through CalAIM, Medi-Cal managed care plans have new opportunities to coordinate and deliver person-centered services. During this webinar, the authors of two recent CalAIM reports will discuss how Community Supports and the institutional long-term care carve-in are positioned to work together to enable more Medi-Cal enrollees to live well in the setting of their choice.

CalAIM Community Supports: Promoting Independent Living Among Older Adults and People with Disabilities

Older Adults with Complex Needs

Through CalAIM, Medi-Cal managed care plans now have the option to offer any of 14 Community Supports that provide person-centered services. This report provides an overview of and evidence summary for six Community Supports most relevant to supporting independent living for older adults and people with disabilities.

Expanding Substance Use Care: Health Plan Teams Up with Seven California Counties

Behavioral Health

In this regional Drug Medi-Cal Organized Delivery System program, the counties provide financial resources, and Partnership HealthPlan of California administers the program.

CalAIM and Institutional Long-Term Care: Lessons for Medi-Cal Managed Care

Center for Health Care Strategies, Decipher Health Strategies, Chapman Consulting

Older Adults with Complex Needs

Starting January 1, 2023, California's CalAIM reform initiative will require that care in nursing homes and other institutional settings be provided as a "carve-in" benefit through Medi-Cal managed care plans statewide. This report describes challenges, opportunities, and lessons learned from select California counties and other states where institutional long-term care has already been administered by managed care plans.

Medi-Cal Quality Strategy Explores Bold Steps Toward Health Equity

January 26, 2022

Christopher Perrone

The strategy will shape how health care will be provided to almost one in three Californians.

Network Adequacy Standards in California: How They Work and Why They Matter

Amy Y. Gu, Michele Ellson, Katherine L. Gudiksen

Health Care Costs

In California, both state and federal laws impose provider network adequacy standards on health plans to ensure that the plans provide meaningful access to health care for enrollees. Yet these standards may put plans at a competitive disadvantage when negotiating contracts with providers such as specialists in short supply. This issue brief outlines considerations for policymakers.

Whole Person Care Pilots Set the Stage for CalAIM

December 9, 2021

Increased community collaboration improves outcomes and saves money for payers.

CalAIM: Why It’s So Much More Than Another New Health Program

December 8, 2021

Medi-Cal, Homelessness & Health Care, Health Equity

While there will be challenges on the journey, the end of the road holds the promise of a more just and compassionate system.

School Mental Health 101: A Primer for Medi-Cal Managed Care Plans

National Center for Youth Law, California Children’s Trust

Behavioral Health

School Mental Health 101: A Primer for Medi-Cal Managed Care Plans introduces managed care plans to California’s vast and complex K–12 education system to help foster partnerships with schools to increase access to school-based and school-linked care for students on Medi-Cal.

CalAIM Explained: Overview of New Programs and Key Changes

CalAIM (California Advancing and Innovating Medi-Cal) will add new programs and make important reforms to many existing programs, bringing in significant federal matching dollars in addition to the millions allocated from the general fund. This explainer provides an overview of all the changes proposed.

Organizations React to Medi-Cal Managed Care Procurement Request for Proposals

Medi-Cal, Health Equity

In June DHCS issued a draft RFP for the first-ever statewide procurement for commercial Medi-Cal managed care plans. CHCF asked organizations to share the comments they submitted to the agency about the RFP. This report presents common themes from across those shared comments.

Advancing Mental Health Equity in Medi-Cal

Behavioral Health, Medi-Cal, Health Equity

CHCF supports the California Pan-Ethnic Health Network in its work to advance equity in Medi-Cal mental health care through research, publications, and its Behavioral Health Equity Collaborative.