Understanding CalAIM for Older Adults and People with Disabilities

California is a state that is continually looking for ways to improve the healthcare system for its residents. That’s why the state government launched a new program known as the California Advancing and Innovating Medi-Cal (CalAIM) in January 2020. CalAIM is a comprehensive initiative with the primary goal of improving the quality of care and health outcomes for Medi-Cal beneficiaries, including older adults and people with disabilities. This article will provide you with an overview of CalAIM, how it works, and its benefits.

What is CalAIM?

CalAIM is a program implemented by the California Department of Health Care Services (DHCS). The program seeks to transform Medi-Cal services by focusing on the following four key goals:

Whole-person care: this is an approach that takes into consideration the social determinants of health, such as food insecurity, housing instability, and mental health. The goal is to provide comprehensive care that addresses both medical and non-medical needs.

Health equity: CalAIM aims to address health disparities by improving access to care and ensuring that all beneficiaries receive high-quality services, regardless of their race, ethnicity, or socioeconomic status.

Behavioral health integration: many people with disabilities and older adults often experience mental health issues such as depression and anxiety. CalAIM intends to integrate behavioral health services to ensure patients receive holistic care.

Long-term services and supports (LTSS) reform: CalAIM seeks to reform LTSS by providing more flexible service and support options.

Who is eligible for CalAIM?

CalAIM is available to all beneficiaries enrolled in Medi-Cal, including older adults and people with disabilities. The program offers a wide range of services, including medical, dental, behavioral health, and long-term care services.

How does CalAIM work?

The CalAIM program is designed to simplify the existing Medi-Cal program and ensure beneficiaries receive the care they need. The program will utilize a variety of innovative strategies such as population health management, value-based care, and alternative payment models. For instance, under population health management, CalAIM will identify patients at risk of developing chronic conditions and provide them with preventive services to reduce the likelihood of developing such conditions. Value-based care will incentivize providers to offer high-quality care by rewarding them based on the outcomes they achieve. The program will also provide beneficiaries with more choice and control over their care by offering multiple service options, such as home-based care and self-directed services.

What are the benefits of CalAIM?

CalAIM has the potential to improve the quality of care and health outcomes for older adults and people with disabilities. Some of the benefits of CalAIM include:

Improved access to care

Holistic care that takes into consideration the social determinants of health

Improved mental health services

Reduced health disparities

More flexible long-term care services and support options

In Conclusion:

CalAIM is a promising initiative that will revolutionize the healthcare system in California. The program aims to ensure that all beneficiaries receive high-quality, person-centered care that addresses their medical needs and non-medical needs. If you are an older adult or a person with a disability enrolled in Medi-Cal, you may be eligible for CalAIM services. Don’t hesitate to reach out to Concise Care Group to learn more about the program.

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