Population Health Management Strategy Workgroup

Population Health Management Strategy

The population health management strategy component of California Advancing and Innovating Medi-Cal (CalAIM) addresses the initiative's objectives of managing member risk and need and improving quality and health outcomes. DHCS currently does not have a requirement that Medi-Cal managed care plans maintain a population health management strategy. Some Med-Cal managed care plans have a population health management strategy, often in response to NCQA requirements, but many do not. In the absence of a strategy, care can be driven by a patchwork of requirements that can lead to gaps in access and a lack of coordination. DHCS proposes that Medi-Cal managed care plans develop and maintain a patient-centered population health strategy. The population health management strategy is a cohesive plan of action for addressing member needs across the continuum of care, based on data driven risk stratification and standardized assessment processes. Each managed care plan would be required include, at a minimum, a description of how it will:

Keep all members healthy by focusing on preventive and wellness services;
Identify and assess member risks and needs on an ongoing basis;
Manage member safety and outcomes during transitions, across delivery systems or settings, and through effective care coordination; and
Identify and mitigate social determinants of health and reduce health disparities or inequities.

Annual Managed Care Plan Open Enrollment

The state has decided not to continue to pursue the Annual Health Plan Open Enrollment policy. This proposal will no longer be a topic of discussion in the Population Health Management workgroup meetings.

Workgroup Charter
Workgroup Roster

Workgroup Meetings

All workgroup meetings will be held in Sacramento at 1700 K Street in the First Floor Conference Room. Please arrive 10 minutes early to sign in at the front desk.

Public Participation

The public is welcome to attend all meetings by phone or in-person. A public call-in option will be active for all workgroup meetings. Please see below.

Note: In-person space is limited and will be allocated on a first come-first serve basis. Members of the public who call in will be placed in listen-only mode. If you wish to participate by phone, please register using the links below (the webinar will be used for telephonic purposes only). After registration, you will receive an email confirmation with your unique dial-in and access code. CalAIM workgroups will not be recorded.