CalAIM's enhanced care management (ECM) program provides a great opportunity for providers to deliver whole-person care while discovering additional revenue to reinvest in your community. A number of managed Medicaid plans (MCPs) are now offering some form of value-based payment. These value-based payments provide incentives to deliver high-quality, cost-effective care that improves patient outcomes and…
Author: Sprite Health
CalAIM’s basic population health management (BPHM)
CalAIM's population health management program requires managed care plans to proactively assess each of their member's health risks and health-related social needs and implement a comprehensive tailored set of services based on their needs and preferences across the continuum of care. CalAIM Basic population health management (BPHM) model is based on the simple principle of providing…
Improving outreach process for ECM and Community Supports
Though some Managed Medicaid plans (MCPs) pay for outreach efforts, most of their payments for ECM and CS services are contingent on successful enrollment. Improving outreach to connect with patients with complex medical and social needs requires a multifaceted approach, and community providers often find that it takes a lot of time to get the…