Bringing Equity to the Forefront with CalAIM

The recent recommended changes for CalAIM and Medi-Cal reform have provided new mechanisms for counties to strongly engage with individuals on targeted Social Determinants of Care (SDoC). These areas are covered under what CalAIM is calling Enhanced Care Management (ECM) where they encourage care management of targeted populations, ensuring that identification and management of comprehensive needs of individuals through whole person care approaches assist with improving quality outcomes and reducing health disparities. 

When talking about one’s health, it is not limited to just physical health. A person’s overall health has to do with mental, emotional, physical and spiritual well-being. It is important to understand all these aspects of a person’s health to truly provide the proper care for that individual. One of CalAIMs goals include managing a person’s overall needs through whole person care approaches and social drivers of health. In supporting Californians' ability to stay healthy in all aspects of life, counties are looking for EHR solutions that have completed the voluntary MU certification on Social Drivers of Health (SDoH) 170.315 social, psychological and behavioral Health. Netsmart was the first behavioral health provider to obtain this certification back in 2017. Beyond this test ONC Engagement also includes:

• Interoperability Standards Advisory (ISA)
• Support for the Gravity Project
• HL7 Cooperative Agreement for IG Development and Piloting

This will help CalAIM improve quality outcomes, reduce health disparities and transform the delivery system through value-based initiatives, modernization and payment reform which will require using the SDoC data, COMBINED with Health data to analyze equity. They also want to help make Medi-Cal a more consistent and seamless system for enrollees to navigate by reducing complexity and increasing flexibility. Check out https://HealthIT.gov/SDOH to learn more about SDoCs and ONC standards and certifications.