CalAIM (California Advancing and Innovating Medi-Cal) promises to strengthen Medi-Cal, offering people a more person-centered approach to provide and receive care in all aspects of life. Based on two waivers, Medi-Cal 2020 Section 1115 demonstration and CalAIM Section 1915(b), along with several State Plan amendments, CalAIM initiatives will improve care coordination, access to services and the overall health of California’s 14 million Medi-Cal enrollees. It is broad-reaching reform, balancing partnerships with providers, managed care plans and community-based organizations, built upon previous pilots such as California’s Whole Person Care pilot and it impacts all aspects of care. There are three main goals that are overarching to the design:
How does CalAIM seek to transform healthcare for Californians? Below are just some of the ways they are revamping healthcare.
Enhanced Care Management (ECM) and Community Supports are foundational components of CalAIM to meet the social needs, including medically supportive foods or housing supports. Community supports are new services provided by Medi-Cal managed care plans as cost effective alternatives to traditional medical services or settings.
Netsmart understands the complexity behind this comprehensive approach. We are working collaboratively with our clients to ensure you have the tools and education needed to meet these new requirements. We created a webinar series, kicking off with an overview of the goals and steps to complete the BHQIP, and continue with a monthly focus on the specific policies. This collaboration and sharing are critical as historically an EHR has been the instrument that many counties used to align their processes, services and data collection with the requests of the state. The depth and extent of CalAIM will require counties to grow beyond an EHR, to a comprehensive population health platform that has visibility into the whole person, beyond just healthcare to providing a catalyst that also advances equity and justice and we are honored to support the success of this exciting initiative.
Wednesday, September 28 | Value-based Care,Thought Leadership
As the upcoming EVV compliance timeline is quickly approaching, we thought it would be interesting to discover how the initial phase and implementation of EVV has affected managed care organizations (MCOs), and their provider networks. This blog recaps a recent Netsmart webinar that addressed the details of this topic with the talented Dr. Melissa Berdell, Director Fraud, Waste and Abuse at Highmark Wholecare.More
Monday, September 19 | Human Services,Thought Leadership,Value-based Care
In our most recent blog, The Role of Peers and Mutual Support in Alcoholics Anonymous, we discussed the fascinating history of Alcoholics Anonymous and its contributions to today's health care continuum. Evolving in parallel to the mental health peer movement, AA and its affiliate organizations, e.g., Narcotics Anonymous came to identical conclusions about the unique value of mutual support. Join Denny Morrison, as he unpacks how often peers are used, how they are credentialed and how they affect the economics of health care in the United States.More
Monday, September 12 | Post-Acute Care,Thought Leadership,Netsmart in the Community,Legislative/Policy
Ready access to quality home healthcare services is critical to the future of our nation’s healthcare system and the millions receiving these services today. Jen Sherman, community strategist, Netsmart will be a voice for home health providers in Washington D.C. at the upcoming NAHC Advocacy Day and shares why the proposed rate cuts by CMS will leave a devastating negative economic and operational impact on home health and post-acute providers.More