More than two million seniors and people with disabilities (SPDs) enrolled in Medi-Cal in California will be impacted by reforms, initiatives, and new policies being developed through CalAIM (California Advancing and Innovating Medi-Cal). CalAIM’s overarching goal is to streamline and create uniformity across the state and counties in services, eligibility, benefits, and delivery systems.
Currently, the organization and delivery of health care and social services for SPDs varies significantly across California counties. The system can also be quite complicated for enrollees, who often interface with multiple delivery systems and programs with various points of entry and differences in eligibility criteria. As CalAIM seeks to reduce this complexity in the long term, in the short term it will involve moving or transitioning SPDs into new or consolidated delivery systems and programs.
This issue brief describes key care delivery transitions that will impact SPDs during implementation of CalAIM, and considerations for this group as they move into new delivery systems — with a focus on addressing health equity by engaging consumers and educating providers. As Medi-Cal managed care plans and provider organizations work together to engage SPDs in these new systems and programs, the information in this issue brief could inform their approach.