Medi-Cal 2020 Overview

Medi-Cal 2020 is a five year renewal of California’s Section 1115 Medicaid Waiver, which could provide California with more than $7.1 billion in new federal funding through programs that will shift the focus away from hospital-based and inpatient care, towards outpatient, primary and preventative care – in other words, from volume to value.

Section 1115 of the Social Security Act allows states to waive certain federal statutory Medicaid program requirements or obtain federal matching funds for costs or investments that would not otherwise be allowed under the Medicaid program. This flexibility allows states to test innovative approaches to care, in an effort to improve quality, access, and efficiency. Waivers can cover all, or part, of a state’s Medicaid program.

All Section 1115 Medicaid waivers include three key elements: budget neutrality, sources of non-federal share, and programmatic components.

Medi-Cal 2020 Programs

The waiver features four new programs that aim to improve care for the state’s Medi-Cal and remaining uninsured patients.

These programs are designed to complement each other in supporting the efforts of California and its public health care systems to create a delivery system that provides preventative and patient-centered care in the right place at the right time to all patients.