MEDI-CAL COV CHAW UA HAUJ LWM HAUJ LWM HAUJ LWM HAUJ LWM HAUJ LWM HAUJ LWM HAUJ LWM: MEDI-CAL KEV PAB CUAM THIAB KEV PAB CUAM​​ 

SACRAMENTO — The California Department of Health Care Services (DHCS) today announced the availability of data showing that Medi-Cal Community Supports are successful and cost-effective. The data show that Community Supports are delivering on their promise to address Medi-Cal member needs—reducing avoidable emergency department visits, hospital stays, and long-term care use while showing strong early signs of cost savings. All 12 Community Supports studied are reducing costs, and of these, nine have already demonstrated cost-effectiveness within the initial study period. The remaining three are projected to reach that threshold over a longer study period, consistent with federal rules for evaluating cost-effectiveness.​​ 

“Community Supports represent a fundamental shift in how we deliver health care to Californians, enhancing quality of care for Medi-Cal members and strengthening the overall efficiency and equity of our health care system,” said DHCS Director Michelle Baass. “These findings confirm that these services are not only improving lives, but also reducing avoidable health care costs. By scaling these supports statewide, we’re making meaningful progress toward a person-centered Medi-Cal system that meets members where they are and prioritizes prevention, dignity, and value.”​​ 

California’s Community Supports were approved in the California Advancing and Innovating Medi-Cal (CalAIM) waivers and phased in by Medi-Cal managed care plans (MCP) beginning in 2022. CalAIM is the state’s initiative to transform Medi-Cal to improve care quality, reduce complexity, and advance equity through data-driven, whole-person care initiatives.​​ 

WHY THIS MATTERS: Medi-Cal currently offers 14 Community Supports. These services promote housing stability, ease transitions from institutional settings, support in-home care, provide healthy meals, and offer caregiver relief, helping members avoid costlier hospital or emergency care. The report analyzed 12 of these supports to assess their impact on health and cost outcomes. These 12 out of 14 Community Supports were studied because they are authorized under California’s 1915(b) CalAIM waiver, which California is required to report on each year to the federal government.​​ 

DHCS submitted its annual 2024 report to the federal Centers for Medicaid & Medicare Services. It analyzes the impact of 12 Community Supports on member health care, including a new cost-effectiveness analysis for calendar year 2023. Key highlights from the report include:​​ 

• Xyoo 2024, ntau dua 494,000 Kev Txhawb Zej Zog tau xa mus rau ntau dua 252,000 tus tswv cuab Medi-Cal.​​ 
• Kaum ob Medi-Cal MCPs thoob plaws 23 lub nroog tam sim no muab tag nrho 14 Kev Pabcuam Zej Zog pom zoo; tag nrho cov MCPs thoob plaws lub xeev muaj tsawg kawg yog yim.​​ 
• Tag nrho 12 cov kev pabcuam tau kawm tau cuam tshuam nrog kev txo qis ntawm cov nqi kho mob hauv tsev kho mob thiab/lossis lub chaw saib xyuas xwm txheej ceev.​​ 
  
  • Cov tswv cuab uas siv tsawg kawg yog ib qho ntawm Kev Pabcuam Housing Trio Community (Housing Transition Navigation Services, Housing Deposits, and Housing Tenancy and Sustaining Services) tau txo cov neeg mob hauv tsev kho mob thiab kev siv xwm txheej ceev ntawm 24.3% thiab 13.2%, feem, hauv rau lub hlis tom qab.​​ 
  • Cov Khoom Noj Kho Mob Kho Mob / Cov Khoom Noj Kho Mob, uas muaj cov tswv cuab coob tshaj plaws tau kawm, tau cuam tshuam nrog kev txo qis hauv kev siv hauv tsev kho mob thiab xwm txheej ceev (21.4% thiab 22.0%, feem).​​ 

COST-EFFECTIVE ANALYSIS: Research showed that 9 of the 12 Community Supports studied are already demonstrably cost-effective, and three are likely to be proven so over time, consistent with federal rules. Members using these services typically saw net reductions in (or offsets of) applicable service costs. Examples include:​​ 

• Kev tso nyiaj vaj tsev raug cuam tshuam nrog 31.6% Net nqi txo.​​ 
• Hnub Habilitation tau cuam tshuam nrog 17.1% tus nqi txo qis.​​ 
• Sobering Centers tau cuam tshuam nrog 11.7% tus nqi txo qis.​​ 
• Kev Pabcuam Respite tau cuam tshuam nrog 61.3% Net nqi txo.​​ 
• Personal Care and Homemaker Services were associated with a 58.4% net cost reduction.​​ 

The cost-effectiveness analysis may be understated due to the short evaluation period, resulting in immediate costs being fully captured but not longer-term savings. DHCS acknowledges that broader initiatives, like Enhanced Care Management, may influence these results. Future evaluations may refine these methods as more data become available, and an independent evaluation will be conducted in line with waiver requirements.​​ 

IMPACT OF COMMUNITY SUPPORTS: The expansion of Community Supports has increased access in rural and underserved areas, with health plans such as Anthem Blue Cross, Health Net, and Partnership HealthPlan of California leading efforts to introduce new services in both urban and rural counties. These three plans are among the largest in the state and demonstrated significant expansion of Community Supports in 2024, both in terms of the number of new services elected and geographic spread, particularly in rural counties. As a result, Medi-Cal members in all 58 California counties now have access to a broad array of Community Supports.​​  

WHAT’S NEXT: DHCS released an updated Community Supports Policy Guide that is aligned with the Enhanced Care Management and Community Supports Action Plan. On July 1, 2025, the new Transitional Rent benefit will be optional for MCPs to offer, and will become the first mandatory Community Support on January 1, 2026.​​ 

DHCS tseem cog lus tias yuav nthuav dav thiab ntxiv dag zog rau Community Supports kom tau raws li kev noj qab haus huv txog kev noj qab haus huv ntawm Medi-Cal cov tswv cuab thoob plaws lub xeev. California tab tom txhim kho nws cov kev siv zog hauv keeb kwm los hais txog kev saib xyuas tag nrho ntawm tib neeg los ntawm kev tiv thaiv, meej mom, thiab kev ruaj ntseg, thaum saib xyuas cov kab hauv qab. Txoj hauv kev no twb tau ua qhov sib txawv, tshwj xeeb hauv kev txo qis kev siv kev saib xyuas kev noj qab haus huv thiab txhim kho kev paub ntawm cov tswv cuab nrog ntau yam kev xav tau kev noj qab haus huv.​​ 

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