CHA News

CHA to Participate in Workgroups Addressing Medi-Cal Innovation

For CEOs, CFOs, government relations staff

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The California Department of Health Care Services (DHCS) has appointed CHA to two important workgroups for its multi-year California Advancing and Innovating Medi-Cal (CalAIM) initiative, which seeks to improve health outcomes for Medi-Cal members through payment, program, and delivery system reforms.

CalAIM’s major focus is to build on the success of various pilots — such as the Whole Person Care Pilots, Health Homes, and the Coordinated Care Initiative — from previous federal waivers, with the goals of improving quality of life for Medi-Cal members, as well as long-term cost savings.   

DHCS will formally release a proposal for the CalAIM initiative at its Oct. 29 Stakeholder Advisory Committee and Behavioral Health Stakeholder Advisory Committee meetings. Throughout the remainder of 2019 and 2020, DHCS will conduct extensive stakeholder engagement for both CalAIM and the renewal of the federal authorities under which Medi-Cal operates (i.e., 1115 and 1915b waivers). Last month, CHA provided DHCS with these considerations for advancing and innovating the Medi-Cal program. 

DHCS’ workgroups will focus on population health management, quality assurance accreditation, enhanced care management, behavioral health, and pilots for integrating physical health, behavioral health, and oral health under one entity.

CHA was selected to represent hospitals on workgroups related to DHCS’ proposal to require Medi-Cal managed care plans to develop and maintain population health management strategies, as well as proposals to integrate county-level mental health and substance use disorder (SUD) programs under a single contract; to revise the medical necessity criteria for behavioral health services; and to potentially pursue the institution for mental disease waiver opportunity.

CHA will engage members in providing feedback to DHCS on its proposal to redesign the Medi-Cal program and will include updates via CHA News.