CalAIM: A Medi-Cal Transformation

California Advancing and Innovating Medi-Cal (CalAIM) is a statewide, five-year, multi-system Medi-Cal transformation that the California Department of Health Care Services (DHCS) launched on January 1, 2022. CalAIM’s goal is to help high-risk, high-needs Medi-Cal members be as healthy as possible. This population accounts for less than 5% of all Medi-Cal members, but as much as half the program’s spending. CalAIM will improve this population’s health while reducing the cost of their care by enabling managed care plans like HPSM to: 

• Deliver comprehensive, integrated medical, dental and behavioral services that address the full range of members’ health care needs.
• Directly address the social drivers of health — such as food insecurity, lack of housing and the youth behavioral health crisis. 
• Use personalized preventive care management to reduce unnecessary emergency room visits, hospitalizations and institutionalizations.
• Eliminate disparities in care based on race, ethnicity and gender to achieve health equity.

CalAIM will serve as a foundation and base for further improving the health care system over time so it better meets people's needs. It includes a wide range of community support programs that health plans can choose to offer based on what will improve the health of their highest-need members and their community generally. CalAIM also offers Medi-Cal managed care plans the opportunity to earn incentive funds that they can use to support local projects that address the social drivers of health. This has enabled HPSM to take on a new role as a community investor in San Mateo County’s future health.

Learn about our CalAIM initiatives