Social service organizations report improvements in social services-health care integration in survey during California’s medicaid initiative (“CalAIM”)
Abstract Background To improve integration across health care and social needs, California’s Medicaid transformation initiative, CalAIM, depends on partnerships between health care entities and social services organizations (SSOs). Given the potential for power imbalance both within the landscape of...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-07-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-025-23419-3 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849389272473272320 |
|---|---|
| author | Abigail Arons Priscilla Alban-Acuna Melora Simon John Whaley Nicole Fossier Amy Simon Rohan Rastogi Caroline Fichtenberg |
| author_facet | Abigail Arons Priscilla Alban-Acuna Melora Simon John Whaley Nicole Fossier Amy Simon Rohan Rastogi Caroline Fichtenberg |
| author_sort | Abigail Arons |
| collection | DOAJ |
| description | Abstract Background To improve integration across health care and social needs, California’s Medicaid transformation initiative, CalAIM, depends on partnerships between health care entities and social services organizations (SSOs). Given the potential for power imbalance both within the landscape of SSOs and between SSOs and healthcare entities, monitoring and elevating SSO perspectives during implementation is paramount. Methods We report the results of the SSO subgroup within a statewide survey conducted eighteen months into CalAIM implementation (July-September 2023, following CalAIM’s January 2022 launch) among a diverse convenience sample of SSO respondents who were familiar with CalAIM. Results were analyzed using multivariable logistic regression models with CalAIM participation and six measures of perceived improvement as outcomes. Results There were 355 SSO employee respondents representing 51 of 58 California counties, 66% of which worked in SSOs contracted as CalAIM providers. CalAIM participation was negatively associated with operating in a single county (OR 0.47, 95%CI 0.24–0.95), and positively associated with pilot participation (OR 6.4, 95% CI 2.5–16.4) and prior managed care contracting experience (OR 2.5, 95% CI 1.4–4.7); pilot participation was negatively associated with fewer employees and non-profit status, indicating a possible mediation effect. Across all six models with outcomes of perceived improvement in health care-social services integration, CalAIM participation was strongly associated with increased odds of perceived improvement (OR 2.28 to 4.97), as was being frontline staff or a manager compared to senior leadership (Manager OR 1.76 to 2.85; frontline OR 1.92–3.35), and being a housing services provider (OR 1.80 to 2.15). Conclusions Our analysis suggests that among SSOs familiar with CalAIM, smaller SSOs were less likely to be contracted CalAIM providers, possibly mediated by lower rates of prior Medicaid contracting experiences (e.g. pilot participation). Contracted SSOs perceived improvements in health care-social services integration at both the patient and organizational levels, suggesting CalAIM is functioning as intended in the perception of SSOs. We demonstrate a feasible method for ongoing monitoring of the SSO perspective that can inform near-term policy directions to ensure small SSOs with close community ties are fully included as partners in CalAIM. |
| format | Article |
| id | doaj-art-aef3a1e52fd9403f846f9c43da641239 |
| institution | Kabale University |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-aef3a1e52fd9403f846f9c43da6412392025-08-20T03:42:01ZengBMCBMC Public Health1471-24582025-07-012511910.1186/s12889-025-23419-3Social service organizations report improvements in social services-health care integration in survey during California’s medicaid initiative (“CalAIM”)Abigail Arons0Priscilla Alban-Acuna1Melora Simon2John Whaley3Nicole Fossier4Amy Simon5Rohan Rastogi6Caroline Fichtenberg7Division of General Internal Medicine at ZSFG, University of California San Francisco (UCSF)Social Interventions Research and Evaluation Network, Department of Family and Community Medicine, UCSFCalifornia Health Care FoundationGoodwin Simon Strategic ResearchGoodwin Simon Strategic ResearchGoodwin Simon Strategic ResearchDivision of General Internal Medicine at ZSFG, University of California San Francisco (UCSF)Social Interventions Research and Evaluation Network, Department of Family and Community Medicine, UCSFAbstract Background To improve integration across health care and social needs, California’s Medicaid transformation initiative, CalAIM, depends on partnerships between health care entities and social services organizations (SSOs). Given the potential for power imbalance both within the landscape of SSOs and between SSOs and healthcare entities, monitoring and elevating SSO perspectives during implementation is paramount. Methods We report the results of the SSO subgroup within a statewide survey conducted eighteen months into CalAIM implementation (July-September 2023, following CalAIM’s January 2022 launch) among a diverse convenience sample of SSO respondents who were familiar with CalAIM. Results were analyzed using multivariable logistic regression models with CalAIM participation and six measures of perceived improvement as outcomes. Results There were 355 SSO employee respondents representing 51 of 58 California counties, 66% of which worked in SSOs contracted as CalAIM providers. CalAIM participation was negatively associated with operating in a single county (OR 0.47, 95%CI 0.24–0.95), and positively associated with pilot participation (OR 6.4, 95% CI 2.5–16.4) and prior managed care contracting experience (OR 2.5, 95% CI 1.4–4.7); pilot participation was negatively associated with fewer employees and non-profit status, indicating a possible mediation effect. Across all six models with outcomes of perceived improvement in health care-social services integration, CalAIM participation was strongly associated with increased odds of perceived improvement (OR 2.28 to 4.97), as was being frontline staff or a manager compared to senior leadership (Manager OR 1.76 to 2.85; frontline OR 1.92–3.35), and being a housing services provider (OR 1.80 to 2.15). Conclusions Our analysis suggests that among SSOs familiar with CalAIM, smaller SSOs were less likely to be contracted CalAIM providers, possibly mediated by lower rates of prior Medicaid contracting experiences (e.g. pilot participation). Contracted SSOs perceived improvements in health care-social services integration at both the patient and organizational levels, suggesting CalAIM is functioning as intended in the perception of SSOs. We demonstrate a feasible method for ongoing monitoring of the SSO perspective that can inform near-term policy directions to ensure small SSOs with close community ties are fully included as partners in CalAIM.https://doi.org/10.1186/s12889-025-23419-3Health related social needsSocial services organizationsCommunity based organizationMedicaidCalAIM |
| spellingShingle | Abigail Arons Priscilla Alban-Acuna Melora Simon John Whaley Nicole Fossier Amy Simon Rohan Rastogi Caroline Fichtenberg Social service organizations report improvements in social services-health care integration in survey during California’s medicaid initiative (“CalAIM”) BMC Public Health Health related social needs Social services organizations Community based organization Medicaid CalAIM |
| title | Social service organizations report improvements in social services-health care integration in survey during California’s medicaid initiative (“CalAIM”) |
| title_full | Social service organizations report improvements in social services-health care integration in survey during California’s medicaid initiative (“CalAIM”) |
| title_fullStr | Social service organizations report improvements in social services-health care integration in survey during California’s medicaid initiative (“CalAIM”) |
| title_full_unstemmed | Social service organizations report improvements in social services-health care integration in survey during California’s medicaid initiative (“CalAIM”) |
| title_short | Social service organizations report improvements in social services-health care integration in survey during California’s medicaid initiative (“CalAIM”) |
| title_sort | social service organizations report improvements in social services health care integration in survey during california s medicaid initiative calaim |
| topic | Health related social needs Social services organizations Community based organization Medicaid CalAIM |
| url | https://doi.org/10.1186/s12889-025-23419-3 |
| work_keys_str_mv | AT abigailarons socialserviceorganizationsreportimprovementsinsocialserviceshealthcareintegrationinsurveyduringcaliforniasmedicaidinitiativecalaim AT priscillaalbanacuna socialserviceorganizationsreportimprovementsinsocialserviceshealthcareintegrationinsurveyduringcaliforniasmedicaidinitiativecalaim AT melorasimon socialserviceorganizationsreportimprovementsinsocialserviceshealthcareintegrationinsurveyduringcaliforniasmedicaidinitiativecalaim AT johnwhaley socialserviceorganizationsreportimprovementsinsocialserviceshealthcareintegrationinsurveyduringcaliforniasmedicaidinitiativecalaim AT nicolefossier socialserviceorganizationsreportimprovementsinsocialserviceshealthcareintegrationinsurveyduringcaliforniasmedicaidinitiativecalaim AT amysimon socialserviceorganizationsreportimprovementsinsocialserviceshealthcareintegrationinsurveyduringcaliforniasmedicaidinitiativecalaim AT rohanrastogi socialserviceorganizationsreportimprovementsinsocialserviceshealthcareintegrationinsurveyduringcaliforniasmedicaidinitiativecalaim AT carolinefichtenberg socialserviceorganizationsreportimprovementsinsocialserviceshealthcareintegrationinsurveyduringcaliforniasmedicaidinitiativecalaim |