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Fact Sheets & Publications

Learn more about the basics of and issues impacting Medi-Cal managed care.

Fact Sheets

Introduction to Medi-Cal Managed Care 
Learn the fundamentals of Medi-Cal managed care, including who it serves, what is covered and how it works.

 

Introduction to Medi-Cal Managed Care Eligibility
An overview of ​who is eligible for Medi-Cal, how an individual becomes eligible and the different pathways to coverage.

 

Introduction to Medi-Cal Managed Care Financing
An overview of how Medi-Cal is funded, how Medi-Cal managed care plans are paid and how DHCS sets the rates it pays to health plans.

 

Publications

Quick Reference Guide: Public Health Care System and Local Health Plan Collaboration
This guide offers early examples of plan-system partnerships and a summary of the key initiatives and policies that drive quality improvement at plans and systems. The guide also shows the increase in overlapping quality measures across the Medi-Cal Accountability Set (MCAS) and Quality Incentive Pool (QIP). The guide can be used to educate staff and support local planning. 

Implementing CalAIM: The Local Health Plan Perspective
A high-level analysis of the early successes of local plans in providing Enhanced Care Management (ECM) and Community Supports services in the first full year of CalAIM.

 

Other Resources

Glossary of Health Care Terms and Acronyms