Hot Topics in Managed Care

American Health Law Association's Health Law Week 2022

On June 9, 2022, Melissa Borrelli presented “Hot Topics in Managed Care” as a panelist during a virtual Educational Call for the American Health Law Association's Health Law Week 2022.

During the fast-paced round-table session, Melissa discussed how managed care is projected to change in the near future. She reviewed social determinants of health (SDOH) and whole person care, to analyze risks and considerations such as:

• California’s ambitious CalAIM program which, will transform Medi-Cal by requiring health plans to partner with community-based organizations to provide services such as housing assistance, home modifications, food, respite care, day habilitation, personal care and homemaker and multiple other services;
• Anticipated adoption of these services and benefits by other states in the near future;
• Requirements of plans to have strong contracts, conduct due diligence and provide education to and appropriate oversight of community-based organizations, most of which have no experience in managed care; and
• Legal and operational risks and considerations of these programs.