MCPs Are Slowing Down Provider Contracting. Here’s What New Providers Should Do About It

If you’re a community-based organization working toward becoming a certified Medi-Cal provider for Enhanced Care Management (ECM) or Community Supports (CS) services, you’ve probably been heads-down building out your infrastructure — writing policies, training staff, setting up your EHR, and preparing your application materials. That’s exactly where you should be. But there’s a shift happening in the contracting landscape that’s worth paying attention to.

At a recent Sacramento PATH meeting, two major managed care plans, HealthNet and Anthem, shared that they have significantly slowed their provider network expansion efforts. Both indicated that their current networks are largely adequate, and while they are still accepting Letters of Interest to keep on file, they are not actively bringing on new providers. Instead, they’re focused on identifying specific gaps in their existing networks.

This is a notable development, but it’s not necessarily a bad one. It signals that CalAIMimplementation is maturing. Managed care plans moved quickly in the early phases of CalAIMto build their provider networks from scratch, and now they’re shifting from broad recruitment into a more targeted approach. For new providers, this simply means the strategy needs to evolve alongside it.

Why Is This Happening?

To understand the current slowdown, it helps to look at the bigger picture. When CalAIM launched, managed care plans had to quickly stand up provider networks for services that, in many cases, had never been delivered at scale through Medi-Cal. That meant casting a wide net and onboarding providers as fast as possible to meet contractual obligations and demonstrate network adequacy to DHCS.

Now that the initial wave of contracting has settled, plans are entering a different phase. They’re evaluating utilization data, looking at where referrals are going, where services are underperforming, and where there are genuine geographic or population-based gaps. This is a more strategic and data-driven approach, and it makes sense from a plan operations perspective.

It’s also worth noting that some plans are managing a large volume of existing provider relationships and may be working through administrative backlogs, quality monitoring, and performance management with their current networks before expanding further.

What New Providers Should Be Doing Right Now

If you’re working toward certification and contracting, this shift doesn’t mean you should stop what you’re doing. It means you should be more intentional about how you position yourself. Here’s what we’re advising our clients:

• Submit your Letter of Interest anyway. Even if a plan isn’t actively contracting, getting your LOI on file means you’re in the queue when gaps are identified. Plans told us directly that they’re keeping these on hand. Don’t skip this step just because the timeline has shifted.

• Build referral relationships with established CBOs. One of the most effective ways to position yourself for future contracting is to be embedded in the local referral ecosystem. If contracted providers are already sending referrals your way or collaborating with you on care coordination, that tells the managed care plan something important about the value you bring to the community. Relationships like these can also lead to subcontracting arrangements, which get you delivering services even before you hold a direct contract.

• Join a provider hub or network. Organizations like Independent Living Systems (ILS), Full Circle Health Network (FCHN), and Partners in Care Foundation serve as connectors between community-based providers and managed care plans. Being part of a hub increases your visibility, gives you access to shared infrastructure, and positions you as part of a coordinated network rather than a standalone entity. Plans are increasingly looking for providers that can plug into larger care delivery systems.

• Strengthen your partnerships with county agencies and local government. Counties play a central role in CalAIM implementation, particularly around housing-related services, justice-involved populations, and behavioral health. Building strong working relationships with county behavioral health departments, housing authorities, probation offices, and social services agencies can make your organization a natural partner when plans look to fill network gaps in those areas.

• Use this time to strengthen your internal infrastructure. There is a silver lining to a slower contracting timeline: you have more time to get it right. Use this window to tighten up your policies and procedures, finalize your staffing model, complete staff training, and make sure your documentation and billing systems are solid. When the contracting opportunity does come, you want to be in a position to hit the ground running, not scrambling to get the basics in place.

The Bigger Picture

The demand for ECM and Community Supports services isn’t going away. California’s Medi-Cal population continues to grow, and the social determinants of health that these services address, housing instability, food insecurity, chronic disease, behavioral health needs, aren’t getting any less complex. The need for community-based providers who can deliver these services with quality and cultural competence is real and ongoing.

What’s changing is the pace and the criteria. Plans are moving from a posture of “we need everyone we can get” to “we need the right providers in the right places.” For new organizations, that means the goal shouldn’t just be certification, it should be strategic positioning. It would also be helpful for the broader CalAIM ecosystem if plans continued to communicate clearly about where their network gaps exist and what they’re looking for in new providers, so organizations can align their efforts accordingly.

This is a moment to get connected, get visible, and get ready. The providers who use this slower period wisely will be the ones best positioned when the next round of contracting picks up.

BlueRidge Management Solutions, LLC

If your organization is navigating the CalAIM certification and contracting process and could use expert guidance, we’re here to help. BlueRidge Management Solutions is a DHCS PATH TA Marketplace approved vendor specializing in helping community-based organizations become certified Medi-Cal providers for ECM and Community Supports services.

Reach out to us at info@blueridgems.com to learn more about how we can support your journey.