CalAIM Six Month Check-Up – Successes and Challenges of Enhanced Care Management and Community Supports Implementation.
A Moderated Discussion Among Health Plan and CBO Leaders from Health Plan of San Mateo and Pacific Clinics.
As we are nearly six months into the launch of the CalAIM initiative, hear perspectives from health plan and CBO leaders on successes and challenges of their ECM and CS implementations. This panel discussion focuses on:
Hosted by Catalyst Solutions and InfoMC
Q : Thank you for bringing the topic of implementation sciences and the drivers involved in each phase. This field seems to be the most neglected, yet I would argue foundational to implementing anything as transformational as CalAIM. Aspirational at DHCS but operational at ground zero which is at clinic levels has at least two broad categories that we need to think through. 1) Are they ready and if not, how can we make them be ready? Pt 2) Are they capable? If not, how can we help them become capable?
Q: It seems that payment coverage of some services through ECM is not going to be as flexible as previous coverage through WPC. One example is programs that engage people with substance use disorders when they are not quite ready to commit to treatment, such as San Mateo’s highly successful Integrated Medication Assisted Treatment program. What prospects do you foresee for such programs to obtain coverage through ECM?
Q: What is working in terms of outreach and getting individuals from the W. P. C. Pilot engaged with the service providers? What is resonating with the clients that are? And are the strategies varying community by community?
Q: Given that Pacific Clinics is in multiple counties, are you finding that the implementation experience differs from one county to the next?
Q: Based on populations of interest, how should the implementation be thought of for future rollouts? For example, what should it look like for the incarcerated population who are returning to the community?
Q: How are the CBOs managing payment slash invoicing back to the health plans? And what is the biggest challenge in this process?