Helpful resources for your team.
Medi-Cal Benefits and Programs
This report explores some design options for implementing MLTSS that policymakers, agency leaders, advocates, and other stakeholders can consider as this work unfolds.
This fact sheet provides an overview of the IHSS program and considerations to strengthen coordination of IHSS with other services.
This fact sheet examines several initiatives that could help support oversight and transparency of Medi-Cal LTSS quality, with the intention to drive improvements in care coordination and delivery.
Health Care Financing
This issue brief illustrates how Medi-Cal is financed and the factors that impact total spending on health services through the program.
Medi-Cal Explained: What Are Alternative Payment Models? explores how Medi-Cal has been developing alternative payment models to align with federal initiatives and state financial and policy goals. It looks at the benefits of these models and barriers to their adoption.
How Health Centers Are Paid is about payment methods for community health centers and Federally Qualified Health Centers, including prospective payment system reimbursement.
Heath Care Industry Insights
CalAIM’s overarching goal is to streamline and create uniformity across the state and counties in services, eligibility, benefits, and delivery systems.
CalAIM (California Advancing and Innovating Medi-Cal) is a comprehensive, multiyear effort led by the California Department of Health Care Services (DHCS) that seeks to implement broad delivery system, program, and payment reform across California’s Medi-Cal (Medicaid) program.
Like their counterparts across the country, California’s Seniors and Persons with Disabilities (SPDs) face serious obstacles and challenges navigating fragmented systems of medical and long-term services and supports to get the care they need.
Medi-Cal Benefits and Programs
To improve access to care for Medi-Cal enrollees, state lawmakers significantly expanded transportation coverage in 2016.This report was commissioned to provide an overview of the implementation and experiences of the NMT benefit.
One in a series of the California Health Care Foundation’s Medi-Cal Explained, this fact sheet provides a high-level overview of the delivery of long-term services and supports (LTSS) in Medi-Cal. LTSS are benefits that support individuals who require assistance with activities of daily living such as bathing, dressing, eating.
Health Care Financing
A fact sheet that breaks down the complicated federal, state, and local funding structure of the Medi-Cal program. Including how it is organized, what funding sources it uses, and the process for developing the Medi-Cal program budget.
A fact sheet that provides a broad overview of Medi-Cal managed care reimbursement. Including an overview of the contracting process, how payment rates are set, and how changes to the Medi-Cal program might impact payment rates. It also previews what is ahead for Medi-Cal managed care plans, including addressing costs and quality, and the move value-based payment for care models.
Heath Care Industry Insights
An examination of the experiences and best practices of subset of Medi-Cal Managed Care Plans that have been successful in raising quality scores over a nine-year period.
An examination of health plan and community-based organization (CBO) collaborations that are working together to address the needs of older adults who have a number of medical and functional needs. And an assessment of strategies, including regulatory and statutory changes, that could better support the integration of the medical and social models of care to address social determinants of health.
A primer on the Medi-Cal program that includes a profile of the population served by Medi-Cal, the application process, available benefits and services, carve-outs or exclusions, responsibility of the oversight entities, performance measurement, financing, pilot programs, and future policy considerations.
