Evolent Health Services

California Medicaid: CalAIM

Issue link: https://knowledge.evolenthealth.com/i/1417172

Contents of this Issue


Page 0 of 1

Mastering Medicaid How Evolent Health Can Help Your Plan Succeed in California's Medi-Cal Reform STRATEGIC PARTNER WITH DEEP EXPERTISE IN WHOLE-PERSON, COORDINATED CARE Is your plan positioned to succeed under Medi-Cal reform taking place throughout the upcoming procurement cycle? More than ever, Medicaid managed care organizations under CalAIM will be asked not only to deliver health care services, but also to address social determinants and other complex challenges facing the state's most vulnerable residents. To thrive, back-office operations and quality initiatives will need to run at peak performance so plans can devote their resources to ensuring top-quality care. With more than a decade of experience and 1M+ Medicaid lives nationally under management, Evolent Health Services offers the know-how and technology to help your plan meet the goals of CalAIM to deliver whole-person-centered care. Below are several areas emphasized in the draft RFP for the upcoming Medi-Cal contract where Evolent could improve your success. Whole-Person Approach to Care As the first organization to earn NCQA accreditation in Population Health Management, Evolent's longstanding approach has focused on earlier interventions, preventive care and a comprehensive view of the whole person beyond a disease state. Evolent's proven evidence-based programs and care models blend clinical and community-based interventions, such as access to transportation and housing. In addition, Evolent's community health workers coordinate clinical, social and community services depending on the member's needs. Care for Medically Complex and Special Populations Evolent has broad experience meeting the physical, behavioral, developmental and oral health needs of special Medicaid populations. We have administered care management programs to foster children, members with substance use disorders, refugees and individuals with intellectual and developmental disabilities, among others. We identify other high-risk patients through a sophisticated risk stratification program that leverages a broad range of data—clinical, social, demographic and more—to identify the highest risk members. A Flexible & Modern Core Administrative Platform Evolent's core administrative platform, Identifi®, offers a "health plan in a box" that manages virtually all aspects of running a managed Medicaid plan. The platform offers a 360-degree view of members' health, utilization, claims and more to enhance coordination among everyone involved in their care. This integrated, holistic IT platform supports the gamut of value-based reimbursement models and quality reporting programs. evolenthealthservices.com

Articles in this issue

Links on this page

view archives of Evolent Health Services - California Medicaid: CalAIM