Strategic Plan 2022-2026

Throughout the planning process, the Alliance identified the need to center on the people it serves rather than the health care services it delivers. Such a shift requires a transformation to honor the dignity and self-determination of members and to focus on their health as the intended result, rather than the delivery of health care services alone. This idea represents an evolution towards a system that yields member health through shared decision making and action, rather than a system that simply delivers health care services.

The state’s CalAIM initiative holds promise to reform programs and payments to improve the quality of life and health outcomes for Medi-Cal members. The Alliance’s five-year goals are in alignment with the goals of CalAIM. and will help the Alliance focus on transformative actions to meet member needs, with members’ improved health and well-being as the long-term goal.

The Alliance will seek to improve the quality and increase member use of behavioral health services through improved coordination, integration and expanded capacity of the behavioral health delivery system. Currently, people with Medi-Cal receive behavioral health services through a complicated, siloed system that requires the member to seek services through different systems depending on severity of mental health or behavioral health diagnosis. The system is not designed to address the member’s expressed need for support or to emphasize prevention, nor does it harness the power of empathy to combat the stigma that prevents healing and recovery. The Alliance seeks to address key impacts of this design, including poorly managed mental health and disparities in utilization across race, age and geographic populations.

The Alliance will engage members and partners to identify and co-create solutions to address barriers to behavioral health services, with an emphasis on providing a culturally sensitive, individualized approach based on a member’s expressed need for support. The Alliance will also work to improve coordination across systems and increase integration of behavioral health services in clinical and non-clinical settings.

Many Medi-Cal members rely on multiple siloed systems to address complex medical and social needs, often without coordination or collaboration across overlapping systems. Social and environmental factors, including a lack of housing, nutritious food and transportation, also have a profound impact on health. There are gaps in delivery system capacity to address those factors because such services are not Medi-Cal benefits or because they fall within shared responsibilities between siloed programs in the delivery system.

To support members with complex medical and social needs to achieve better health outcomes, the Alliance will rely on a population health-based approach and will increase data sharing with providers and community-based organizations to more effectively collaborate and coordinate patient care. The Alliance will also partner with providers and community-based organizations to improve the capacity for community-based care coordination (where members live, work, learn and play). In order to avoid long-term poor health and to improve member health outcomes, the Alliance will partner with community stakeholders to identify and address gaps in services that could support member health. The Alliance will also seek to integrate supportive services that address health-related social needs into the health care.