Section Update

CalAIM Presents Opportunities, Raises Questions for Hospitals


  • Northern Sierra Section hospitals


With its many significant changes, the state’s launch of the California Advancing and Innovating Medi-Cal (CalAIM) program presents opportunities but also raises some questions. One question is how CalAIM’s enhanced care management and community supports will benefit the patients who hospitals serve. Another is where does it make sense for hospitals to participate in these new programs. Hospital Council is convening meetings of hospitals in Partnership Health Plan counties to explore these questions and to determine the next steps. Similar discussions are being explored in counties where California Health & Wellness and Anthem share responsibility for CalAIM. 

In conversations to date, all agree that CalAIM’s enhanced care management and community supports services are much needed, especially since they would help patients who hospitals frequently see. But challenges exist in many rural areas where providers (e.g., nongovernmental organizations and nonprofits) who offer enhanced care management and community supports are not able to deliver fully on what is proposed.