Join us on March 7 for a panel with experts discussing the 1115 Waiver and AHEAD opportunities

State of California
Medi-Cal Transformation - CalAIM

California Advancing and Innovating Medi-Cal (CalAIM) is a multiyear waiver to transform California’s Medi-Cal program and enable it to work more seamlessly with other social services for the state’s most vulnerable populations. CalAIM provides a unique opportunity to invest in and build population health management capabilities for health systems, IPAs, medical groups, FQHCs and CBOs.

COPE Health Solutions (CHS) is a vendor on the
CalAIM TA Marketplace with state funding available to support your organization’s success with CalAIM:

  1. CalAIM Strategic Alignment & Operational Readiness Assessment
    • In-depth assessment of infrastructure capabilities against CalAIM requirements
    • Align current business objectives & strategy to maximize CalAIM benefits and funding to achieve the greatest impact and ROI
    • CalAIM implementation roadmap to support provider transformation and care model redesign
  2. CalAIM Process and Best Practice Redesign, Implementation and Optimization
    • Data capture, analytics, and reporting
    • Managed Care Plan contracting, billing and claims
    • Member identification, stratification and outreach
    • Documentation and workflows
    • Social Determinants of Health assessments & community partner engagement
    • Provider communication & engagement strategies
  3. CalAIM Enhanced Care Management (ECM) Care Model Design and Integration
    • Care Model and Clinical Redesign tailored to populations of focus
    • Care Team Structure and Education/Training
    • SDOH and CBO Integration and Coordination
    • HEDIS Quality and SDOH Gap Closure
    • Patient Outreach and Engagement
  4. Data & Technology Infrastructure
    • Configuration of analytics and data models to meet CalAIM requirements and identify target populations
    • Risk stratification for high-risk member identification, outreach & enrollment
    • Platform & technology best practices to accelerate member engagement & improve clinical quality outcomes
  5. ECM/CS Provider Identification and Engagement
    • Asset mapping of providers within identified service areas
    • Strategic alignment & cross sector collaboration
    • Contract development & performance management
    • Operational workflows and care plans that can be shared across entities to support collaborative efforts
  6. Managed Care Contracting
    • Comprehensive financial modeling to support assessment of financial implications and operational requirements
    • Development of contracting terms & operational tools for quality and performance management
  7. Workforce Development
    • Development and implementation of customized competency based CalAIM training programs (e.g., analytics, care models, member engagement)
    • Development and implementation of hiring processes, employee engagement and training and performance management tools
    • Implementation of workforce pipeline & onboarding solutions

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CalAIM Experts