CalAIM (California Advancing and Innovating Medi-Cal) is a sweeping initiative designed to improve care for high-need Medi-Cal members by introducing delivery system and payment reforms. ECM is a statewide benefit offering intensive, person-centered care coordination for selected “populations of focus”—those experiencing homelessness, serious mental illness, substance use disorders, frequent hospitalizations, and transitions from incarceration or institutions.

What CBOs Need to Know

• CBO participation requires formal contracts with Managed Care Plans (MCPs), compliance with new privacy and data reporting standards, and the capacity to deliver intensive, multi-disciplinary care.

• ECM services are anchored in the community and may include health promotion, transitional care, and family support—usually led by a care manager helping coordinate physical, behavioral, and social services.

• Community Supports (In Lieu of Services) complement ECM, providing social needs services like housing navigation, food supports, and more, with CBOs often delivering both types of intervention.

Strategic Steps for CBOs

• Assess organizational fit: Review infrastructure, staffing, and administrative readiness to handle CalAIM requirements and reporting.

• Identify local MCP partners and understand contracting priorities—many CBOs start with the MCP holding the largest county market share.

• Join county PATH collaborative groups for peer support, technical assistance, and community partnerships.

• Decide whether to contract as a solo provider or work through an intermediary/network for shared services and risk mitigation.

Key Challenges & Opportunities

• Smaller CBOs may face barriers related to financial risk, contract administration, and data system upgrades but benefit from newly available infrastructure funding and technical assistance (PATH Marketplace).

• CalAIM opens up essential new revenue streams for CBOs serving complex populations, while promising a person-centered, prevention-oriented approach to care, focused on health equity and social drivers of health.

Successful CBO engagement with CalAIM ECM requires preparation, relationship building, and strategic adaptation to evolving Medicaid service models in California.