CBO-Health Plan Contracting Under CalAIM And The Competitive Social Care Market

8/16/2023 – It has been a year since the implementation of the California Advancing and Innovating Medi-Cal (CalAIM) initiative, which aims to create a more coordinated and person-centered Medicaid system. CalAIM mandates that managed care plans (MCPs) offer enhanced care management (ECM) and allows for coverage of 14 types of optional community supports (CS). ECM offers intensive care coordination of health and health-related services to address medical and non-medical needs of the highest-need members. CS is designed to meet members’ social determinant of health needs, including medically supportive foods or housing navigation. This ambitious reform has brought significant changes to the market landscape; it has sparked expectations of increased cross-sector partnerships between MCPs and community-based organizations (CBOs) and a boost in CBO capacity to provide ECM and CS.

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