Provider Support Helping Members

California Advancing and
Innovating Medi-Cal (CalAIM)

The Department of Health Care Services (DHCS) contracted with Anthem Blue Cross (Anthem) to implement the California Advancing and Innovating Medi-Cal (CalAIM) program. CalAIM will improve the quality of life and health outcomes of our members by implementing broad delivery system, program and payment reform across the Medi-Cal Managed Care program.

CalAIM leverages Medicaid as a tool to help address many of the complex challenges facing California’s most vulnerable residents, like homelessness and insufficient behavioral health care access. Meanwhile, it will focus on the increasing number of justice-involved individuals with significant clinical needs, individuals with complex medical conditions and the growing aging population.

CalAIM has three primary goals:

  1. Identify and manage member risk and needs through whole-person care (WPC) approaches and addressing social determinants of health (SDoH).
  2. Reduce complexity and increase flexibility in the Medi-Cal program.
  3. Improve quality outcomes and drive delivery system transformation through value-based initiatives, modernization of systems and payment reform.

This proposal will integrate:

  • Medi-Cal Managed Care
  • Existing WPC Pilots populations
  • Existing Health Home program populations
  • Drug Medi-Cal Organized Delivery System
  • Community-based adult services (CBAS)
  • Long-term care
  • SDoH-related services and more

Provider Resources