March 12, 2021 - The California Advancing and Innovating Medi-Cal (CalAIM) proposal is a set of reforms to expand, transform, and streamline Medi-Cal service delivery and financing. This post—the third in a series assessing different aspects of the Governor’s proposal—analyzes CalAIM’s potential to reduce health disparities, and therefore promote health equity.
February 28, 2020 - In this report, we provide an overview and assessment of the Governor's California Advancing and Innovating Medi-Cal (CalAIM) proposal, also known as Medi-Cal Healthier California for All. CalAIM would make far-reaching reforms to Medi-Cal that would increase the program’s focus on its high-cost and high-needs enrollee populations, transform and streamline Medi-Cal managed care, extend components of a current federal waiver, and rethink how behavioral health services are financed and delivered.
February 9, 2021 - The California Advancing and Innovating Medi-Cal (CalAIM) proposal is a set of reforms to expand, transform, and streamline Medi-Cal service delivery and financing. This post—the first in a series assessing different aspects of the Governor’s proposal—provides a brief overview of CalAIM, summarizes key changes from last year’s withdrawn proposal, and analyzes overarching issues related to CalAIM.
March 15, 2021 - The California Advancing and Innovating Medi-Cal (CalAIM) proposal is a far-reaching set of reforms to expand, transform, and streamline Medi-Cal service delivery and financing. This post—the fourth in a series assessing different aspects of the Governor’s proposal—analyzes CalAIM proposals targeted at seniors and persons with disabilities, including new benefits and structural changes to how long-term services and supports (LTSS) are administered. (LTSS include, among other supports and services, institutional care in nursing homes and home- and community-based services such as home care and personal care services.)
February 16, 2021 - The California Advancing and Innovating Medi-Cal (CalAIM) proposal is a set of reforms to expand, transform, and streamline Medi-Cal service delivery and financing. This post—the second in a series assessing different aspects of the Governor’s proposal—analyzes CalAIM financing issues, including both the Governor’s funding plan for CalAIM as well as CalAIM’s policy changes related to Medi-Cal financing.
May 21, 2021 - In this post, we provide our preliminary comments on the Governor’s 2021‑22 May Revision proposal for Medi‑Cal. We first provide an overview of the proposal, noting the major changes made relative to the Governor’s January budget, as well as changes made to estimated 2020‑21 spending relative to the January estimates. We then describe, and provide our comments on, the Governor’s proposal to augment the January proposal for the California Advancing and Innovating Medi‑Cal (CalAIM) package. We follow with descriptions of, and comments on, the Governor’s modified telehealth policy proposal, the proposal to extend full‑scope Medi‑Cal coverage to older undocumented immigrants, and the proposal to use American Rescue Plan Act funding to provide financial relief for designated public hospitals.
March 21, 2018 - This budget brief analyzes the Governor’s 2018-19 budget proposal to eliminate the use of the 340B Drug Pricing Program in Medi-Cal. The Governor’s proposed statutory changes are intended to generate state savings and reduce the administrative complexity of complying with federal law on duplicate discounts when 340B prescriptions drugs are dispensed to Medi-Cal enrollees. We find that the Governor’s proposal merits serious consideration from the Legislature since, among other benefits, it would likely result in state savings that the Legislature could, in turn, use to fund its priorities. We note, however, that these savings would be in place of savings currently enjoyed by eligible healthcare providers. Before making a decision on the Governor’s proposal, we recommend that the Legislature ask the administration to provide the following key information on the Governor’s proposal: (1) the amount of Medi-Cal savings that would be generated, (2) the impact on healthcare providers currently participating in the 340B Program, and (3) the trade-offs of alternative policy approaches to addressing the challenges that are present due to the use of the 340B Program in Medi-Cal.
March 3, 2022 - This brief analyzes the Governor’s three major behavioral health budget proposals. We include analyses of the Governor’s proposals to (1) provide funding for behavioral health bridge housing, (2) provide funding to implement certain solutions developed by the felony incompetent to stand trial solutions workgroup, and (3) add mobile crisis intervention services as a new Medi-Cal benefit.
February 28, 2023 - Presented to: Assembly Committee on Health Assembly Budget Subcommittee No. 1 on Health and Human Services
October 24, 2022 - This post summarizes overall spending in the 2022-23 budget package for health programs. It is part of our Spending Plan series, which contains posts focused on each major sector of the state budget.
October 23, 2023 - This post summarizes overall spending in the 2023-24 budget package for health programs. It is part of our California Spending Plan series, which contains posts focused on each major sector of the state budget.
February 17, 2012 - California’s system for providing health and social services to low-income seniors and persons with disabilities (SPDs) receiving Medicare and/or Medi-Cal is not coordinated. This lack of care coordination may lead to SPDs being unnecessarily hospitalized or placed in skilled nursing facilities rather than remaining in their own homes—resulting in poor outcomes for recipients and higher costs for the federal and state governments. As part of the 2012-13 budget, the Governor attempts to address this issue by proposing to integrate health and social services into managed care for most SPDs. In this report, we provide background information on the Medi-Cal and Medicare Programs and describe recent federal and state legislation to address fragmented care delivery. We discuss the potential merits of the Governor’s proposal, but raise several implementation issues and concerns. Finally, we make recommendations that encourage care coordination for SPDs by first completing and evaluating a currently authorized integrated care demonstration project in four counties rather than expanding the demonstration statewide as proposed by the Governor— an action that we think is premature. We also encourage the consideration of other ways to test the integration of benefits for SPDs.
February 16, 2023 - This brief analyzes the Governor’s three major behavioral health spending proposals and two proposed behavioral health budget solutions involving delays in planned spending.