Anthem Blue Cross (Anthem) is working with the Department of Health Care Services and several county and local partners to implement the California Advancing and Innovating Medi-Cal (CalAIM) program. CalAIM is designed to improve the quality of life and health outcomes of our members by implementing a broad delivery system, program, and payment reform across the Medi-Cal Managed Care (Medi-Cal) program.
CalAIM leverages Medi-Cal 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:
This proposal will integrate:
Intensive care coordination services will be provided at the community level to address physical health, behavioral health, and psycho-social needs.
Enhanced Care Management (ECM) is comprised of seven core services, including:
Enhanced Care Management is designed to assist the following populations of focus:
For more information on the Enhanced Care Management Services program and core services, please review the CalAIM ECM flier.
In lieu of services (ILOS) are a menu of services, which, at the option of a Managed Care Plan and a member, can substitute for covered Medi-Cal Managed Care services as cost-effective alternatives. ILOS providers are entities with experience and expertise providing one or more of the ILOS to individuals with complex physical, behavioral, developmental, and social needs.
DHCS has approved the following services:
Please review the available in lieu of services overview.
Interested providers for ECM and/or ILOS should complete a Letter of Interest form:
If you have questions regarding CalAIM, please contact us at CalAIM@anthem.com