The Health Economics and Evaluation Research (HEER) Program at the UCLA Center for Health Policy Research has shared findings from an interim evaluation of two major statewide initiatives to improve health care delivery for Medi-Cal beneficiaries.

The California Department of Health Care Services selected the HEER Program to evaluate two demonstrations called Providing Access and Transforming Health (PATH) and Community Supports, authorized under California's landmark Section 1115 Medicaid Waiver initiative, California Advancing and Innovating Medi-Cal (CalAIM). 

The UCLA team is conducting a mixed-method evaluation of these demonstrations, which includes an assessment of how California managed care plans and their contracted providers implemented these programs, what challenges they faced, and what lessons they learned.

The findings are part of a 755-page UCLA-RAND Interim Evaluation Report that summarizes early implementation results from five interrelated evaluation components — PATH, Global Payment Program, the Medi-Cal Matching Plan Policy for Dually Eligible Beneficiaries, the Justice-Involved Reentry Initiative, and Community Supports. Together, these efforts demonstrate the state’s progress toward creating a more integrated Medi-Cal system designed to improve health outcomes, strengthen local infrastructure, and address members’ social and behavioral health needs.

The evaluation also examines the outcomes, including whether PATH developed the capacity of various organizations in California to provide Enhanced Care Management (ECM) or Community Supports to Medi-Cal beneficiaries.

The PATH evaluation showed substantial growth between 2022 and 2024 in provider participation, service availability, and member utilization of ECM and Community Supports, which increased from 82,088 members in early 2022 to 256,406 members by the third quarter of 2024. The total number of members who had ever used these services in the interim reached 500,447.

This expansion was driven in part by financial support under PATH, which helped community-based providers build staffing capacity, technology systems, and data infrastructure to coordinate care and meet contracting requirements with managed care plans.

The Community Supports evaluation showed:

• Increases in the number of managed care plans offering each Community Support and counties in which they were offered.
• Increases in the number of contracted providers and the number of contracts per provider for all Community Supports between 2022 and 2024, although there were slight decreases between 2023 and 2024 for half of the Community Supports.
• More users for all Community Supports, although total number of users of some supports remained fairly low.
• Managed care plans and providers perceived the lack of housing to be a barrier to house members experiencing or at-risk of homelessness.

The interim results highlight both the complexity and promise of the CalAIM transformation — illustrating how state-level innovation, paired with local implementation and continuous evaluation, can drive sustainable improvement in health care delivery. The final evaluation report, which is planned for release in mid-2028, will include assessments of whether delivery of these services led to better patient experiences, better quality, better health, and more efficiency.

The California Department of Health Care Services based these demonstrations on the success and lessons learned from the HEER team's evaluations of the Whole Person Care and Health Homes Program demonstrations.