Full-stack platform to deliver personalized care at scale and improve financial outcomes
CalAIM is a new initiative from Medi-Cal, designed to offer Medi-Cal members (who are enrolled with managed care plans) more holistic, equitable, person-centered care. CalAIM includes 14 Community Supports - optional health-related services that are offered by Medicaid managed care plans (MCPs) to address social drivers of health. Medically supportive food/meals/medically tailored meals (MTM) is one of…
ECM (enhanced care management) and Community Supports (CS) benefits are targeted to high-cost, high-need members who will gain the most from from the whole-person, interdisciplinary, community-based care management services. It is the responsibility of managed care organizations (MCOs) to identify the right members based on DHCS defined eligibility criteria and connect them to the right…
Letitia is a 40-year-old female with Type-2 diabetes and Asthma living in suburbs with her two small children. She is eligible for Medicaid due to her low income and is currently enrolled in a managed care plan. A few months ago, she injured her back and has trouble driving to work and working full-time. She…