Medicaid agencies across the country are working on innovative initiatives that address both the health and social needs of older adults and people with disabilities. Many of these initiatives involve expanding existing provider networks or developing new provider networks in areas such as social services, care management, institutional care, and Medicare. In California, Medi-Cal, the state Medicaid agency, launched an ambitious statewide initiative known as California Advancing and Innovating Medi-Cal (CalAIM) to transform services for those with the greatest needs and costs. I am working on an initiative. As part of this initiative, California’s Medi-Cal Managed Care Plans is expanding its network of health and social service providers to better meet the needs of older adults and people with disabilities.
Under CalAIM, managed care plans contract with community-based social service providers and care management organizations to provide non-medical community support and enhanced care management services to those with the most complex care needs. California’s managed care plans also strengthen its network of institutional long-term care providers, including skilled nursing, subacute, and intermediate care providers. In addition, many plans that serve people with both Medicaid and Medicare entitlements build a network of Medicare providers in creating a coordinated dual-eligible special needs plan called a Medicare Medicare plan. .
This blog post, made possible by the California Health Care Foundation, explores California and managed care plan considerations when strengthening provider networks to ensure the health and social needs of older adults and people with disabilities are met. Make sure. It focuses on strategies for partnering with his three major provider types: (1) community-based organizations, (2) long-term care facilities, and (3) Medicare providers. Lessons from California’s managed care plans are highlighted throughout and can inform managed care organizations in other states.
Read the full post from the Center for Health Care Strategies.