Advancing CalAIM in Ventura County, California, through effectively scaling an Enhanced Care Management program focused on cohorts of patients with both clinical and non-clinical resource needs
CalAIM (California Advancing and Innovating Medi-Cal), a state and federally funded 1115 Medicaid Waiver program, was introduced to health systems in 2021 offering contracting for targeted individuals for Enhanced Care Management (ECM) services. Targeted individuals are those with complex care needs including the homeless population, recently incarcerated, and patients with substance disorders. Contracting for this program is done between health systems and payers, who are offering monthly incentives for care management responsibilities.
Ventura County Health Agency (VCHA) is leveraging the power of data and collaboration to advance their population health program and care delivery strategies and embracing the CalAIM program to scale its predecessor, Whole Person Care, in their mission to provide access to care for the underserved and those facing barriers to access. Through focused efforts between IT and clinical operations, VCHA has connected data sources from labs, EHR, and payer claims, and expanded their care management solution capabilities with Oracle Health. Ventura has been able to gain the insights needed to operationalize and advance their care management program resulting in increased engagement and impact with some of their patients most in need.
Join this webinar to hear from VCHA, a fully integrated, comprehensive system of hospitals, clinics, and specialty services, as they dive into how they’ve been able to use data and technology to focus on this Medicaid reform initiative.
Watch the Recording
Learning Objectives
After participating in this activity, the learner should be better able to:
- Understand how informaticists and clinical ops teams can collaborate to launch the program within their health system
- Recognize the importance of garnering grant funding and revenue stream initiatives to support technical and clinical work efforts
- Learn strategies to expand current care management solution to meet program requirements
- Create specific algorithms to surface potential case lists
- Capture required data elements to support billing requirements
- Generate reporting for program oversight
Also hear about other areas of interest and future development:
- Coding requirements for capturing SDOH factors
- Data/file sharing with payers
Presenters
Deanna Handel
Deanna Handel, MPH brings over 20 years of experience administering health programs serving children and adults with complex physical needs and social determinants of health issues. In her current role as the Director of Complex Care Coordination for Ambulatory Care, Deanna oversees programs that serve some of Ventura County’s most vulnerable and high-need populations including overseeing the implementation of CalAIM Enhanced Care Management, and Community Supports, and a robust street-based outreach team. Much of her work involves intensive coordination with Community Based Organizations, Managed Care Plans, contract providers, and across all levels of government.
Lisa Hahn
Lisa Hahn leads a CalAIM User group for 12 Oracle Health clients across California focused on shared strategies for operationalizing CalAIM within a wide variety of health systems. Her background includes supporting community hospitals with their strategic initiatives by aligning Oracle Health solutions with project goals and oversight. Prior to Oracle, Lisa worked for Cerner and also Manifest Medex, a state-wide HIE in California in a role helping ambulatory practices leverage patient data. A resident of California but New England native, Lisa has found the health care landscape in California to be both dynamic and at the forefront of health equity initiatives and she appreciates partnering with health systems like VCHA who embrace this moment of transformation.
