CalAIM Data Exchange Roadmap


Learn About the Critical Role Data and Information Will Play in Supporting California Medicaid’s New Enhanced Care Management Benefit and In Lieu of Service Model—and How Stakeholders Can Exchange and Use Vital Information.

In 2022, the California Department of Health Care Services (DHCS) will launch California Advancing and Innovating Medi-Cal (CalAIM), an ambitious and innovative program designed to address the complex physical, behavioral and social needs of Medi-Cal’s most vulnerable members. Building on the state’s Health Home Program (HHP) and Whole Person Care Pilots, CalAIM envisions enhanced coordination, integration and information exchange among managed care plans (MCPs); physical, behavioral, community-based and social service providers; and county agencies to support new benefits and services, including:

  • Enhanced Care Management (ECM), a collaborative and interdisciplinary approach to providing intensive and comprehensive care management services for Medi-Cal members with complex physical, behavioral and social needs
  • In Lieu of Services (ILOS), cost-effective, health-supporting services that may be substituted for existing State Plan-covered services to reduce hospitalization and institutionalization, reduce cost, and address underlying drivers of poor health

Many ECM and ILOS program participants will have limited experience seamlessly coordinating services they provide with other health system providers, and may have limited health information technology capacity to do so—yet their participation and ability to share and use administrative, health and social service information will be vital for program success.

In this webinar, funded by the California Health Care Foundation and supported by DHCS, Manatt Health will:

  • Describe how ECM and ILOS program stakeholders will be expected to share and use information to fulfill program functions;
  • Identify legal and regulatory, technical, financial, and operational barriers to information sharing across program stakeholders; and
  • Outline specific actions that California policymakers, government agencies, MCPs and providers can take to mitigate them.

For more information on CalAIM, please find the state’s recently updated Proposal here and Executive Summary here.

Presenters:

Aaron Toyama, Senior Advisor for Health Care Programs, California Department of Health Care Services
Jonah Frohlich, Managing Director, Manatt Health
Kevin McAvey, Senior Manager, Manatt Health

Date and Time

Friday, February 26


If you would like to receive an audio transcript of this webinar due to accessibility issues, please email us at webinars@manatt.com.

This program does not constitute legal advice, nor does it establish an attorney-client relationship. Views expressed by presenters are strictly their own and should not be construed to be the views of Manatt or attributed to Manatt.

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