California Advancing and Innovating Medi-Cal

(CalAIM)

CalAIM Components

To better identify and manage the risk and needs of members who may be challenged with medical and behavioral conditions, lack of access to care, or chronic illnesses and disabilities, CalAIM is a whole-system, person-centered approach that will result in a better quality of life for members, as well as long-term cost savings and avoidance. Components of this system include:

A statewide population health management strategy
A statewide Enhanced Care Management (ECM) benefit
Implementation of optional Community Supports
Implementation of incentive payments for plans and providers
Participation in the serious mental illness (SMI)/serious emotional disturbance (SED) demonstration
Required screening for and enrollment in Medi-Cal prior to release from county jail
A pilot with full integration of physical health, behavioral health and oral health under one contracted entity in a county
A long-term plan for foster care children and youth

Return to Main CalAIM Page

Providers and other health care professionals with questions regarding Medi-Cal, OneCare Connect, OneCare or PACE can call the Provider Relations department at 714-246-8600 or email providerservices@caloptima.org
Provider Reference Contact List

Provider Directory

Find a Provider
CalOptima Health works with over 3,700 Orange County physicians, making it easy for our members to get the care they need.

Check here for our extensive list of providers, health networks, medical groups, hospitals and pharmacies.

Claims

About Claims and Eligibility
Verify member eligibility or submit a request for treatment authorization.

Provider Trainings

Trainings by Topic
View the latest model of care and other educational materials designed to help you and your staff provide care for CalOptima Health members.

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