CalAIM Launches Program to Reform Housing and Health Care Coverage in California
A new program launched this year out of California called CalAIM helps high-risk and low-income Medi-Cal residents find affordable housing through their health insurance plans.
The CalAIM program is intended to improve health outcomes of Medi-Cal enrollees, specifically those with behavioral health needs, seniors, people living with disabilities, those transitioning from jail or prisons back to the community or those experiencing homelessness. It also helps children with complex medical conditions and those in foster care.
The program will allow managed care plans to couple clinical care with a range of new non-medical services reimbursed by MediCal. These non-medical services include housing support, medical respite, personal care, medically tailored meals and peer support.
The program will also require public health systems to be more responsive and equitable by focusing on population health and matching the right patients to the right services at the right time. It will implement payment reforms for physical and behavioral health providers based on outcomes rather than services.
The activities that CalAIM will cover require a waiver approval from the Centers for Medicare and Medicaid Services, and those waivers were finalized by CMS in December 2021.
The Department of Health Care Services is implementing CalAIM in partnership with Medi-Cal providers, Managed Care plans, counties, community-based organizations and other stakeholders, with the first reforms effective Jan. 1, 2022, and subsequent reforms to be phased in through 2027, according to a document from DHCS regarding the timeline for implementation.
Alexa can be reached at [email protected]