California’s Rural Health Transformation (RHT): From Fragmented Access to Regional Care Networks
California is undergoing a major shift in how health care is delivered, financed, and sustained for rural communities, driven by state priorities and recent Centers for Medicare & Medicaid Services (CMS) announcements. In December 2025, CMS announced $50 billion in funding through the five-year Rural Health Transformation (RHT) Program, along with ACCESS and LEAD ACO. […]
What You Need to Know About California’s DHCS $145M CITED Awards
With the release of the California Department of Health Care Services’ (DHCS) fourth and final PATH CITED funding round, $145.5 million were distributed to 153 organizations across all 58 counties in California to further support CalAIM program development.
What You Need to Know About California’s DHCS $145M CITED Awards
With the release of the California Department of Health Care Services’ (DHCS) fourth and final PATH CITED funding round, $145.5 million were distributed to 153 organizations across all 58 counties in California to further support CalAIM program development. Awards were given to organizations that provide Enhanced Care Management (ECM) and Community Supports services including in-person care coordination, […]
Preparing for OBBA (H.R. 1): How Medi-Cal Plans Can Reduce Attrition and Protect Member Coverage Under New Eligibility Rules
The One Big Beautiful Bill Act (OBBA) introduces the most significant transformation of Medicaid eligibility since the Affordable Care Act (ACA), placing ACA Expansion Adults at higher risk of coverage loss and exposing large Medi-Cal health plans to $40 to $50 million in annual capitation risk. Beginning December 31, 2026, states must implement six-month redeterminations […]
5 Things to Know About California’s Medicaid Waiver Renewal
California’s CalAIM (California Advancing and Innovating Medi-Cal) initiative is approaching a pivotal milestone as its federal waiver is set to expire at the end of 2026. Launched in January 2022 under a Section 1115 demonstration waiver, CalAIM represents a major reform effort aimed at transforming how Medi-Cal serves its most vulnerable populations. Operated by the […]
How We See CalAIM Impacting Maternal Health Organizations
Providing equitable maternal health care is of growing interest across the nation. Disparities in access to maternal health services, including prenatal, perinatal, and postpartum care that meet the unique needs of various populations disproportionately impact Black, Indigenous, and other communities of color, leading to poor maternal health outcomes. For example, Black women are 2-3 times […]
From Lessons to Action: CalAIM’s Impact and the Future of Medi-Cal
Medi-Cal Transformation is evolving and the lessons learned since its launch in 2022 have created significant discussion throughout California and other states regarding opportunities to leverage lessons learned in California for Medicaid redesign and in other states for their own Medicaid transformation and waiver efforts. Medi-Cal transformation, formerly known as California Advancing and Innovating Medi-Cal […]
Measuring Your MSO: The Key to Growth and Premium Retention
As healthcare organizations navigate a rapidly evolving landscape shaped by value-based care, population health, and payer-provider realignment, many providers are turning to Management Services Organizations (MSOs) to enhance operational efficiency and fuel growth. Whether you’re an independent practice, a medical group, or an emerging provider network, evaluating the size and scope of your MSO is […]
Enhanced Care Management for Justice-Involved Individuals: Evidence-Based Strategies Under CalAIM
Justice-involved individuals (JIIs) reentering society often face a complex mix of challenges: Chronic health conditions, mental health and substance use disorders, unstable housing, limited job prospects, and a deep distrust of systems. The first 90 days after release are critical. Without solid, coordinated care, many fall through the cracks increasing the likelihood of adverse health […]
Navigating Medi-Cal Changes: Strategic Considerations for Health Plans, Providers, and Community Partners
California’s Medi-Cal program is facing a period of fiscal tightening that we have not seen since the enactment of the Affordable Care Act back in 2010. Driven by both state-level budget constraints and federal policy proposals, cuts will be real and painful. With the Medi-Cal program’s costs projected to exceed $194 billion by FY 2025-26, […]