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