CalAIM Community Supports: Initial Lessons Learned & Recommendations

by Health Net

Health Net is one of California’s longest serving Medi-Cal partners. That’s why the company is working with the state to transform Medi-Cal. California Advancing and Innovating Medi-Cal (CalAIM) is the state’s long-term commitment to offer California’s most vulnerable residents a more equitable, coordinated and person-centered approach to a healthier life.

Since CalAIM launched in January, Health Net has developed early lessons learned and recommendations for the healthcare community. The recommendations are specifically focused on the “Community Supports” benefits offered as part of CalAIM.

Community Supports benefits are critical because Medi-Cal members often experience health disparities at a higher rate because of social drivers of health. These drivers include, but are not limited to, health literacy, housing availability, food insecurity, implicit bias and more.

Lessons Learned & Recommendations

Three main lessons were noted in the “CalAIM Lessons Learned Issue Brief”. To read the full brief, click here.

One of the main lessons is that extensive collaboration with plan partners and providers is paramount. The key finding found that Health Net and their plan partners worked together to lessen administrative burdens on providers, counties and others. They extended this model of teamwork and support to their relationships with local providers. The recommendation is to work together with plan partners, in line with the vision and goals of CalAIM. Lean into the deep knowledge of local providers who are trusted advisors to the community. Their county-specific knowledge is crucial to deliver culturally responsive care. This care is needed to help reduce health disparities in the Medi-Cal population.

Another main lesson learned about CALAIM is the foundational need for operational support and funding for local providers. The key finding is that Health Net brought many Community Supports providers into the company’s network who were new to Medi-Cal managed care. The development of infrastructure, capacity building and operational support was key to meet DHCS program requirements. A lot of training and funding helped providers prepare to deliver care from day one of implementation. The recommendation is to continue to invest in workforce development, training and recruitment to build new capacity. Invest in technology to support service efficiency and reach.

Lastly, the essential role of timely and complete data sharing is an important lesson learned. The key finding showed accurate data allowed Health Net to understand the Community Supports needs of the people they serve. This informed how and where they are implementing Community Supports and which providers are best suited to serve their Medi-Cal members. The recommendation is to use connected information systems that offer integrated data on social drivers of health. This ensures Medi-Cal members receive the care they need. Closing the information loop between Community Supports programs and community-based organizations will result in a more seamless beneficiary experience.

Looking Ahead: Next Phase of CalAIM Implementation

As the state implements CalAIM through 2027, Health Net remains committed to CalAIM’s success. Yet, despite all the planning by the state, Health Net and our partners, implementation of CalAIM is a massive and complex initiative.

There have been bumps in the proverbial road and challenges undoubtedly lie ahead. To address those challenges requires a proactive, collaborative approach. That’s because Health Net and other health plans can only move as quickly as local resources allow.

However, Health Net is committed to providing the necessary resources to build the capacity required to serve Medi-Cal members who need CalAIM services.

To read about other issues facing California’s most vulnerable residents, visit Health Net’s resource library on the company’s Bridging the Divide website.

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