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Preparing For CalAIM – Expanding Health Plan Contracts With Managed Care Plans For Complex Medi-Cal Youth

March 9, 2023

The five-year California Advancing and Innovating Medi-Cal (CalAIM) initiative is one year into the 2022 launch of the Department of Health Care Services (DHCS) program. Now through 2027, the Medi-Cal delivery system will transform Medi-Cal using a population health approach, prioritizing prevention and whole person care. Under CalAIM, Medi-Cal beneficiaries will receive coordinated and equitable access to services addressing physical, behavioral, development, dental, and long-term care.

During the initial year, 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 and primary care providers and community-based organizations (CBOs), developed new services to meet new plan requirements—focused heavily on intensive case management and addressing social determinants of health through in lieu of services.

These covered services are being expanded to cover complex Medi-Cal youth as part of the 2023 roll out. In this one-hour session, executive leaders from managed care plans 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. Richard Louis, III, OPEN MINDS Vice President West Region, will lead a discussion on developing these new contracts, target measures and outcomes, and aligning payer and provider goals.

Executive attendees of this session will learn about:

  • Understand Managed Care Plan requirements to become a contract provider organization
  • Understand the process and steps for developing a new contract
  • Learn the target measures and outcomes that demonstrate success in serving the complex Medi-Cal youth population

Details

Date:
March 9
Time:
1:00 pm - 2:00 pm
Event Categories:
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Website:
https://openminds.com/?p=1018708

Featured Speakers

Richard Louis, III, Vice President, OPEN MINDS

As OPEN MINDS Vice President – Western Region, Richard Louis, III, 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 help create programs that target high cost and complex behavioral health populations.


Registration is free and requires an OPEN MINDS Circle account, which you consent to OPEN MINDS creating on your behalf if one does not exist. For access to the full line of market intelligence, including executive briefings, industry news, state and organizational profiles, RFPs, and datasets from the specialty health and human services market contact us at 855-559-6827 or info@openminds.com to become an OPEN MINDS elite member.

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