The Latest On CalAIM: Expanding Health Plan Contracts With Managed Care Plans
Gettysburg, Pa. (July 2, 2023)— As part of Medi-Cal reform, new Medi-Cal Managed Care Plan contract opportunities were made available to provide Enhanced Care Management (ECM) and Community Support (CS) services for complex adults with severe mental illness (SMI). Under these contracts, specialty organizations, primary care provider organizations, and community-based organizations (CBOs) developed new services to meet the new plan requirements.
To help executive teams with this ongoing shift, OPEN MINDS is hosting an Executive Roundtable, Preparing For CalAIM – Expanding Health Plan Contracts With Managed Care Plans For Complex Medi-Cal Youth. The session, being held virtually on July 13 at 1:00 pm ET, will be moderated by Richard Louis, III, OPEN MINDS Vice President West Region, and feature Neeta Alengadan, Associate Vice President of Healthcare Services at Molina Healthcare of California, and Eric Schwimmer, Director for Enhanced Care Management at Anthem Blue Cross’ Elevance Health. They will share their plans for expanding ECM and CS services to this new segment. Executive attendees will hear a recap of 2022 efforts, what is coming in 2023, and contract start dates and implementation timelines.
“The question is how to develop a sustainable strategy for new service delivery, evidence-based practices, service process management, and new reimbursement approaches,” said OPEN MINDS chief executive officer Monica E. Oss. “Health and human service executives must combine that with an understanding of managed care plan requirements and the process of developing new contracts.”
To register for the July 13 roundtable, visit https://register.gotowebinar.com/register/3889321604746655063. There is no cost to register, but a free membership in the OPEN MINDS Circle is required.
This roundtable is part of OPEN MINDS quarterly CalAIM series and OPEN MINDS Circle Elite Executive Roundtable sessions, designed to help executive teams navigate the business, organizational, operational, and cultural changes of a market in turbulence. Each one-hour briefing outlines a field-tested approach for recovering from a crisis and developing a plan for organizational sustainability.
Richard Louis, III, Vice President – Western Region for OPEN MINDS, brings extensive experience as a behavioral health care administrator, business development specialist, and innovator of new service lines for behavioral health care organizations. His expertise in population health management program development, strategic planning, and payer mix diversification helped create programs that target high-cost and complex behavioral health populations.
Neeta Alengadan, Associate Vice President of Healthcare Services of Molina Healthcare of California is a health care executive with 10+ years of experience at Molina Healthcare, most of which is with the California health plan. Graduating with a Bachelor of Science degree in Business Administration, with a concentration in Finance and Business Information Technology, Neeta first joined Molina Healthcare as a as a Member Services Representative with the Member and Provider Contact Center. As she was promoted to leadership positions within the contact center, Neeta gained experience in implementation of several new initiatives such as SPD mandatory enrollment, Medicaid expansion, Cal MediConnect/Duals Demonstration, and Covered CA. She has been critical in the implementation of the CalAIM initiatives, specifically overseeing Enhanced Care Management (ECM) and Community Supports (CS), as well as DHCS incentive programs for CalAIM, Housing and Homelessness and Student Behavioral Health. In her current role as the Associate Vice President of Healthcare Services, Neeta oversees Program Development, Behavioral Health, Enhanced Care Management (ECM), Community Supports (CS), Incentive Programs and internal auditing.
Eric Schwimmer is Anthem Blue Cross’ (Elevance Health) Director for Enhanced Care Management, one of several Medi-Cal CalAIM initiatives. Eric previously led Anthem’s Medi-Cal’s Whole Person Care, Health Homes and Long-Term Services and Supports programs through which he developed an expertise in cross-sector and integrated models of care and related health plans operations. Prior to joining Anthem, Eric worked with health care advocacy and community-based organizations to develop cross-sector care coordination projects. Eric is passionate about population health and participatory approaches to serving vulnerable populations.
About OPEN MINDS
OPEN MINDS is a national market Intelligence, management consulting, and marketing services firm specializing exclusively in the markets of the health and human service field that serve consumers with chronic conditions and complex support needs. OPEN MINDS mission is to provide payers, service provider organizations, and technology and scientific firms that serve these consumers with the market and management knowledge needed to improve their organizational efficiency and effectiveness. Learn more at www.openminds.com.