In 2022, the California Department of Health Care Services (DHCS) will launch an ambitious and innovative program targeting the complex physical, behavioral, and social needs of Medi-Cal’s most vulnerable members. The California Advancing and Innovating Medi-Cal (CalAIM) program will build on the plan-based Health Home program and district-based whole-person care pilots that use holistic care approaches to address the underlying social determinants of health.
CalAIM provides for improved coordination, integration and the exchange of information between managed care plans (MCPs); Providers of physical, behavioral, community and social services; and district authorities by establishing new benefits and services, including Enhanced Care Management (ECM) and In Lieu of Services (ILOS).
Manatt Health and the California Health Care Foundation have teamed up to create a new implementation roadmap – “CalAIM and Health Data Sharing: A Roadmap for Effective Implementation of Enhanced Care Management and In Lieu of Services” – which enables data and data sharing – and information system barriers identifies identifies for the implementation of ECM and ILOS program functions and offers a range of recommendations and measures for policy makers, government agencies, MCPs and providers. The roadmap addresses three categories of barriers to data sharing and the steps required to mitigate them, including:
- Regulations and guidelines to facilitate the secure exchange of information
- Technical infrastructure and standards to support the efficient collection, exchange and use of member information
- Financing, contracting, and operating, with matching incentives, contracts, and tactics critical to institutionalizing programs and ensuring their long-term success
click Here to read the full roadmap.