What Is CalAIM?
CalAIM, or California Advancing and Innovating Medi-Cal, is a multiyear process led by the California Department of Health Care Services (DHCS) to improve the health outcomes and quality of life experienced by Medi-Cal enrollees.
CalAIM is a far-reaching, multi year plan to transform California’s Medi-Cal program so it can integrate better with other social services. Led by California’s DHCS, the goal of CalAIM is to improve outcomes for the millions of Californians covered by Medi-Cal, especially those with the most complex needs.
What Are the Goals of the CalAIM Initiative?
- The CalAIM Initiative will make services more standardized and equitable across the state, bringing consistency to the current patchwork of programs that vary by county.
- Ensure the Californians who need the most help actually get it — by emphasizing proactive outreach to bring people with complex needs into care and offering a “no wrong door” approach to people seeking help.
- Enable Medi-Cal Managed Care Plans (MCPs) to pair clinical care with a range of new non medical services called Community Supports. Those services, which will be reimbursed by Medi-Cal, include housing supports, medical respite, personal care, medically tailored meals, and peer supports.
- Incentivize public health systems to be more responsive, equitable, and outcome focused by:
- Focusing on populations health, which involves matching the right patients to the right services at the right time, increasing equity.
- Implementing payment reform to lay the foundation for paying providers based on outcomes rather than services (value-based care).
- Ensuring greater accountability for Medi-Cal MCPs by requiring them to coordinate access to services provided by counties and community-based organizations.
Who Will CalAIM Help?
While CalAIM’s broad reach is intended to help all Medi-Cal enrollees, many of the reforms focus on improving care for people with the most complex needs. This group includes:
- People with significant behavioral health needs, including people with mental illness, serious emotional disturbance, and/or substance use disorder
- Seniors and people living with disabilities
- People experiencing homelessness who also have complex physical or behavioral health needs
- People transitioning from jail or prison back to the community who also have complex physical or behavioral health needs
- Children with complex medical conditions, such as cancer, epilepsy, or congenital heart disease
- Children and youth in foster care
Timeline for CalAIM Implementation
The first CalAIM reforms were implemented in January of 2022, and additional reforms will be phased in through 2027. Work is actively underway to ensure a smooth transition from existing programs to CalAIM as reforms are approved.
Source: CalAIM Explained: A Five-Year Plan to Transform Medi-Cal
How is Axiom Behavioral Health EHR Software Preparing for CalAIM?
AxiomEHR is focused on continuously learning about CalAIM requirements at both the state and county levels. We ensure our customers have built-in compliance features to ease their transitions and meet deadlines.
Axiom is a modern, user-friendly, EHR software solution designed for behavioral health agencies. Our team has worked in California with our legacy product, Exym for 20+ years, and is a trusted partner for California billing and compliance.
Axiom’s configurable, intuitive platform empowers providers to improve outcomes, simplify billing, and boost overall agency efficiency.
With features like voice-to-text notes, built-in telehealth, a client portal app, and other easy-to-use tools, Axiom helps clinicians save time and focus on client care.
Want to learn more? Schedule a quick chat with an Axiom expert who can answer your questions today.
