5 slides: Lessons learned through the implementation of CalAIM – the case for reform

On Wednesday, 3 experts from various silos across the California healthcare landscape gathered for a virtual “5 Slides We’re Discussing” talk at the State of Reform to discuss the lessons they’ve learned so far as CalAIM’s implementation continues statewide.

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Our virtual chats included Martha Santana Chin, President of Medi-Cal at Health Net, Kathryn Bailey, CEO of San Diego Wellness Collaborative, and Robert Jones, Founder and CEO at Roots Food Group. The conversation was hosted by Verne Smith of Reform State, Ph.D.

Santana-Chin offered a Health Net form for implementing CalAIM Community Support. Health Net has implemented community support across all 31 counties in which it operates, and has confirmed that this implementation has included strategies largely centered around health equity, local participation, and local investments and partnerships.

“[Community Support services] They are really important because many of the individuals that Medi-Cal serves today have a higher degree of inequality simply because they have higher social risk factors,” Santana Chin said.

“We know that health care equity begins at the community level and is best served locally, so we’ve partnered with local organizations to build a strong, responsive provider network that integrates non-traditional Medi-Cal providers into the state’s Medi-Cal safety net. We have invested more than 100 $1 million in more than 500 community organizations, and these investments over the years have truly allowed organizations to pilot and advance promising ideas that are now truly foundational. [CalAIM’s Community Supports]. “

Santana Chen also discussed Health Net’s best practices for effective implementation of community support. She emphasized the need for extensive collaboration with plan partners and providers, operational support and financing for local service providers, and full and timely data sharing.

Bailey showed some of the key lessons learned from the first 9 months of applying CalAIM at the San Diego Wellness Collaborative. She said the cooperative was leveraging the strengths of San Diego County’s community-based organizations to offer the benefits of CalAIM Enhanced Care Management and Community Support at a grassroots level.

She commented on some of the challenges she noted during the first phase of CalAIM implementation, particularly with partnerships between managed care plans and community-based organizations.

“These are new partnerships in many ways,” Bailey said. “While many CBOs have community engagement-type relationships with health plans, they have not had contractual and operational relationships. These are really new ways of working together, and we just have to realize that new ways of working together take time.”

The fourth slide, provided by Jones, discussed the potential benefits of CalAIM Clinically Designed Meals, a partner in Roots Food Group. Jones noted that the 3-year DHCS pilot program for clinically designed meals resulted in a 32% net health care cost savings, 63% decrease in hospitalizations, a 50% increase in medication adherence, and a 23% increase in the likelihood of infection. Hospital discharge.

Jones emphasized the importance of food security in addressing the social determinants of health.

“Many chronic diseases are transmitted through food, and [these diseases] They make up 80-90% of total healthcare costs. “If you eat the right foods, you can put your type 2 diabetes into remission. You get to your health very quickly.”

View the full conversation over here.

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