The Future Of California Is Today—and It’s With Netsmart

Our commitment to provide quality care to the residents of California matches yours. As a long-time partner of California, we understand its vast and diverse market landscape. That’s why nearly 80% of the state’s care flows through Netsmart technology. You deserve someone who understands you. Why take a risk when we are fully equipped, vetted and California proven!

929 M+

Health Information Exchange transactions* in California

76 %

of population covered
by Netsmart clients

$ 3 B+

in claims processed
for California annually


*2017-2022 year-to-date transactions

   CalAIM

We're built for CalAIM. Let us help you.

Meeting CalAIM requirements can be overwhelming, but together we can deploy the right technology and create a roadmap for success. CalAIM is centered around the whole-person care model – something that Netsmart has done for years.

  • One platform that supports all behavioral health needs for whole-person care
  • Advanced solutions to help you provide more equitable, coordinated and person-centered care for California populations
  • Technical advising and support to make sure you have the tools and flexibility to meet CalAIM requirements not just on time, but early––and with a lot less complexity

   Enhanced Care Management (ECM)

The experts you need for Enhanced Care Management

As a statewide Medi-Cal benefit, Enhanced Care Management aims to provide comprehensive care and achieve better health outcomes for the highest need individuals. ECM builds on current whole-person care pilots and transitions those services and individuals to this new managed care plan. Netsmart is fully aligned to support coordinated care for populations of focus, including:

  • Individuals/families experiencing homelessness
  • Individuals at risk for avoidable hospitalizations
  • Individuals with serious mental health and/or SUD
  • Individuals transitioning from incarceration
  • Individuals identified to be at clinical high risk for psychosis
  • Nursing facility residents transitioning to the community
  • Individuals up to age 26 with a history of involvement in the child welfare system

Netsmart offers a single population health management platform for the populations of focus, combined with years of experience working closely with California counties to support programs like the Interim Housing Outreach and Full-Service Partnership. Our specialized capabilities include:

  • Comprehensive care coordination that auto assigns individuals by zip code, program, status and risk, to increase speed and efficiency of outreach
  • Robust data that presents the whole picture of an individual with metrics that align with ECM program requirements
  • Integration with managed care plans, including MIF, RTF and OTF file exchange, to support individuals and ensure revenue cycle stability

   Community Supports

Keeping healthcare in the community

Drawing from past programs like Whole Person Care and Health Homes, Netsmart is fully equipped to enable the Community Supports or In Lieu of Services program as part of ECM. Our focus on interoperability and integrated care gives you the technology for prevention and risk stratification, as well as community care coordination. We believe that individuals should obtain care in the least restrictive setting possible and remain in the community as medically appropriate. Community Supports can potentially decrease high-cost utilization of nursing facilities and emergency departments.

Population Health Icon CARE Court

Simplifying the complex. Serving the most vulnerable.

Netsmart’s population health management solution is designed to support the comprehensive care coordination for CARE Court in California. We have the tools to help drive coordination across various organizations while ensuring care managers can provide the correct documentation for the individual involved.

  • Allows multiple care management programs to exist in a single solution, from substance use support to housing authorities to corrections facilities
  • Generates actionable analytics for proactive care to meet the needs of high-risk populations
  • Helps you navigate the complex legal system while providing highly specialized care with external document sharing

Interoperability matters

Interoperability is the digital exchange of information between entities. It’s the technology that drives whole-person care and allows programs like CalAIM, ECM and CARE Court to serve Californians in need. Netsmart solutions have set the industry standard in interoperability and care coordination for years. Our technology drives the market as human services increasingly span the care continuum, achieving quality, effective outcomes. Netsmart is committed to helping you meet and exceed the requirements for interoperability today – and every day after.

Learn more about Interoperability
Mike Valentine

“We look forward to supporting Shasta County across a variety of programs, services and funding opportunities that CalAIM brings to their community and helping make whole-person care a reality for those they serve.”

– Mike Valentine, CEO, Netsmart

Learn More

From the CareThreads Blog

Medi-Cal Enhancements and How Netsmart Can Help

Medi-Cal Enhancements for at-Risk Populations: What Does it Mean for Providers?

Friday, April 05 | Legislative/Policy,Care Coordination,Human Services

Two programs are at the forefront of behavioral health in California: Enhanced Care Management/Community Supports and CARE Court. These are significant advancements to Medi-Cal and are expected to yield improved care outcomes. What do providers need to know?

More

Bringing Equity to the Forefront with CalAIM

Friday, June 24 | Thought Leadership,EHR Solutions and Operations,Care Coordination

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).

More

CalAIM’s next step for California’s whole person care utilizing Care Management and Care Coordination

Wednesday, July 13 | Thought Leadership,EHR Solutions and Operations,Care Coordination

As Governor Gavin Newsom stated, “[CalAIM] is a once in a generation opportunity to completely transform the Medicaid system in California”. To move towards this transformation means intensive care coordination services will need to be provided at the community level to address not only physical and behavioral health, but psychosocial needs as well.

More

DID YOU KNOW?

To better serve you, we have a dedicated support line specifically for you, our California myAvatar™ clients. This provides prioritization in call queue to aligned support associates who know and understand California workflows.

1.800.249.2285

Ready to learn more?

What do you say, ready to join the rest of California? We know you, and we'd like for you to get to know us too. Click below to discover how our powerful partnerships and technology support California specific requirements and align with CalAIM and the data exchange framework today.

Connect Today