Skip to main content

Is your care management platform compliant with CalAIM?

California Advancing & Innovation Medi-Cal Enhanced Care Management (CalAIM) is designed to improve the level of whole person care that is given to the population. This is especially true for members that need additional help and non-traditional services in order to be able to attend to their physical health and wellbeing. This includes individuals who don’t have housing, transportation, and/or need assistance with getting meals to live a healthy lifestyle.

How can care management platforms support these vulnerable members with complex needs and be compliant with CalAIM?

A member-centric approach is key – where the care management platform coordinates all the pieces of their healthcare, including care management, utilization management, and access to healthcare services and support. With this, it is imperative that each member has a comprehensive care plan that includes all facets of their health, and their providers can access that plan and collaborate on it.

What should you be looking for in a care management platform to meet CalAIM’s requirements and support vulnerable populations?

  1. Evidence-based Assessments for Diverse Population Needs

Safety net populations represent a complex and diverse set of members and healthcare needs. To support them, care management platforms need to provide a comprehensive, customizable set of evidence-based assessments and the ability to centrally manage care from one application for all healthcare needs/providers.

  1. Utilization Tracking & Budget Management

Members with complex needs, especially when part of a population with challenging circumstances, need to clearly and easily understand what services they truly need, what their benefits are, and how to access those services.

It’s critical that the care management platform can:

  • Assess their healthcare & support services needs
  • Understand their benefits

With this information, the care management platform can drive their plan of care, which can also drive their need for some of the enhanced care management services.

  1. Mobile Application

A comprehensive care management platform with a mobile application empowers the care team to meet the member where they are and still be able to assess them in offline mode. Care is no longer dependent on a member’s transportation or won’t be interrupted because of lack of internet access.

One of the biggest challenges CalAIM is facing is reaching and supporting the homeless population. Care management platforms that are mobile and don’t rely on the internet enable care providers to support these members.

 GuidingCare and Whole Person Care

GuidingCare care management platform was purpose built to be able to serve the most complex and vulnerable populations. From the start, GuidingCare’s member-centric approach has been focused on coordinating all aspects of member’s care. GuidingCare offers over 260 evidence-based assessments that drive care plans and can be configured to meet specific state and population requirements. Learn more here.