Californians, like the rest of the country, are facing significant mental health challenges in the aftermath of the pandemic. The need for new and enhanced behavioral health supports and interventions has come into strong focus in recent years and states are leveraging their Medicaid programs to respond.

In November 2022, United States Senators Cassidy, Carper, Scott, Warner, Cornyn, and Menendez issued a request for information (RFI) regarding approaches for improving coverage for individuals who are dually eligible for Medicare and Medicaid. Dual eligible beneficiaries are more likely to have  complex health needs that are difficult and often expensive to treat. Too often, they experience a lack of integration and coordination that often results in confusing encounters with the health care system and negative health outcomes.

In November 2022, United States Senators Cassidy, Carper, Scott, Warner, Cornyn, and Menendez issued a request for information (RFI) regarding approaches for improving coverage for individuals who are dually eligible for Medicare and Medicaid. Dual eligible beneficiaries are more likely to have  complex health needs that are difficult and often expensive to treat. Too often, they experience a lack of integration and coordination that often results in confusing encounters with the health care system and negative health outcomes.

Enhanced Care Management (ECM) and Community Supports are core components of CalAIM, a multiyear initiative led by the California Department of Health Care Services (DHCS) that take a person-centered approach to social service delivery and care management for individuals with complex health and social needs.

Recruitment and retention of the direct care workforce has been a longstanding challenge among states. Low wages are a particular barrier because direct care worker wages often compete with gig employment, where the work is less physically and emotionally taxing.

In a new Health Affairs Forefront piece titled “As Medicaid Continuous Coverage Requirement Ends, Randomized Controlled Trials Can Minimize Churn” with co-authors Jacob Wallace and Atheendar Venkataramani, professors at the Yale School of Public Health and the Perelman School of Medicine at the University of Pennsylvania, respectively, we discuss the opportunity to use RCTs to identify strategies for communicating with Medicaid enrollees that will help minimize coverage loss.

Thanks to tireless advocacy combined with impressive outcomes data, funding was allocated in the California state budget to support the continuation of the program. This is a prime example of how initial federal investments can ultimately lead to long-term sustainability of successful programs.

On Tuesday, June 28, 2022, Aurrera Health Group and Milliman experts gave an in-depth presentation to applicants of the CMS ACO REACH model and/or current Direct Contracting Entities.

In July 2021, California Governor Gavin Newsom signed into law AB 133, which calls for the development and implementation of a statewide Health and Human Services Data Exchange Framework — consisting of a data sharing agreement, policies, and procedures — to govern the exchange of health information among health care entities and government agencies by January 31, 2024.

When Aurrera Health launched the ACEs Aware initiative on behalf of the California Department of Health Care Services (DHCS) and the Office of the California Surgeon General (CA-OSG) in late 2019, we knew we were on the forefront of change.

A core element of all Medicaid Section 1115 “research and demonstration” waivers is an evaluation of the demonstration program and its efficacy in meeting the demonstration’s goals. Historically, however, Section 1115 waiver evaluations have been an afterthought for states and CMS, limiting their ability to inform future Medicaid policy and financing approaches.

States are leveraging American Rescue Plan Act (ARPA) dollars to support a multi-faceted policy approach to strengthening state health care infrastructure and the health workforce.

Last year, Aurrera Health Group teamed up with the California Department of Health Care Services to provide early education and targeted technical assistance for providers on implementing Enhanced Care Management and Community Support services, two key parts of the CalAIM initiative. This experience revealed several promising practices for other states pursuing whole-person approaches to health care delivery.

The health care system is moving toward acknowledging substance use disorders (SUD) as chronic illnesses, yet only about 10% of people with an SUD in the last year received treatment.