CA SB910

Requires each Medi-Cal managed care plan to implement a population health management program by January 1, 2022, to identify, assess, and manage the health needs of enrolled beneficiaries.

Mandates Medi-Cal managed care plans to conduct enrollee assessments, risk stratify beneficiaries into meaningful subpopulations, and establish models of care addressing health needs across the care continuum.

Requires plans to report to the Department of Health Care Services on case management services provided (basic, complex, and enhanced care management) and in-lieu-of services, including the number of enrollees receiving such services.

Directs the department to establish metrics for evaluating program effectiveness and require the federally mandated external quality review organization (EQRO) to evaluate enhanced care management and in-lieu-of services and analyze each plan's population health management program.

Requires Medi-Cal managed care plans to consult with stakeholders including county behavioral health departments, public health departments, providers, community-based organizations, consumer advocates, and Medi-Cal beneficiaries in developing and implementing the program.