Changes to Medi-Cal Program

The State of California has embarked on multiple efforts over the last few years to transform the way health care is delivered in the Medi-Cal program.

These efforts illustrate Governor Newsom’s larger vision for reform, including those that hold promise to improve outcomes for children. California Advancing and​ Innovating Medi-Cal (CalAIM), managed care plan reprocurement, the Comprehensive Quality Strategy, and the Children and Youth Behavioral Health Initiative are all examples of these efforts. Details on each of these areas of work have been recently released that indicate how the needs of children and their families are being considered in different ways.

This blog outlines new Medi-Cal benefits and initiatives currently being implemented by the California Health and Human Services Agency (CalHHS) and the Department of Health Care Services (DHCS). It also reviews how children and their families may be impacted.

CalAIM. CalAIM is a long-term plan to transform Medi-Cal. The stated goal is to create a health care delivery system that is more equitable, coordinated​, and person-centered.​​​​ CalAIM’s first reforms started in January and additional changes will continue through 2027.

While CalAIM is intended to help all Medi-Cal enrollees, many of the reforms focus on improving care for people with complex needs, like individuals experiencing homelessness and those exiting the criminal justice system. Among children, focus populations include those with complex medical conditions or who are in foster care. Recently, DHCS convened a CalAIM Children’s Advisory Group, signaling an opening to consider the specific ways that CalAIM may lead to innovation for all children.

Read the full article here.