Relationships with our providers are at the heart of Full Circle Health Network’s Community Care Hub model. Providers have access to a dedicated person who knows them, understands their unique needs, and guides them on the journey to becoming a CalAIM service provider and then helps them manage and grow their ongoing programs.
This partnership between the provider and their Provider Success Manager starts the moment a provider starts working with us. And it is a relationship – the providers aren’t just given a checklist and wished good luck, they get a coach who helps them along the way.
Setting The Stage
Providers show up with different levels of readiness. Some are already enrolled in Medi-Cal and submitting claims for similar programs. They want to work with Full Circle for the pre-built systems, quality monitoring and billing support. Others are brand new to Medi-Cal, managed care and need help building the basics from scratch. Full Circle sorts providers into tiers based on how much support they need to get moving, then matches the coaching based on the provider’s strengths and needs.
As one coach put it: “There’s no such thing as being behind.” Every provider moves at their own pace, and they’re not expected to get there solo. “Each provider has their own process. We reassure them that they’re not alone. If they have a question or concern, usually another provider has it, as well.”
Every provider must demonstrate readiness by working through a checklist of items ranging from certification, licensure, enrollment, insurance, documentation training, platform setup, compliance. It looks and feels like a lot from the outside. That’s one reason why the coaches exist. They are an email or phone call away to answer questions about whatever comes up. They have a relationship so it’s not like sending inquiries into a void – unclear if they’ll get a response.
Building Skills
Getting a provider through the readiness checklist is not the end of the journey. After all the training is done. Providers need to actually start delivering services in the way Full Circle expects, with real fidelity to the network’s care model, not just paperwork that checks a box. The coaching at this stage is also critical.
Full Circle offers many resources at this stage.
Model of Care Support.
Full Circle coaches organizations on how to implement new services within their care delivery ecosystems, breaking down what might at first seem like complex processes into components that busy managers can implement. We bust persistent myths about what’s possible under CalAIM, partnering closely with providers every step of the way. Our vantage point working with 16 different MCPs gives us insight to different approaches and allows us to advocate for what we see works best for community organizations and beneficiaries.
Quality Improvement Strategies
Our systematic approach to quality improvement aims to elevate each provider’s care delivery capacity, competency, and consistency.
Providers can attend regular office hours and access a library or training materials. We’ve developed shared tools, policies, and training programs that create consistency across our network without sacrificing the unique cultural strengths that make each organization effective in their community.
The provider success coaches help them find answers to their questions.
Billing and claims support
Our payment operations extend beyond basic billing support to include financial planning, revenue optimization, and sustainability consulting. We help organizations understand their financial performance, identify opportunities for growth, and develop strategies for long-term sustainability that reduce dependence on uncertain grant funding while maintaining mission alignment.
The “you’re leaving money on the table” moment
Provider success coaches often see providers already delivering billable services but not understanding how they can modify those programs to be billable services. Organizations come to Full Circle already running programs like housing support, case management, community outreach, without recognizing that the people they’re serving may be ECM-eligible.
A housing provider working with young people from foster care, for instance, may not realize that population overlap alone can unlock a new funding stream. “That can be really just mind-blowing,” a coach said, “that they’re leaving a substantial amount of money on the table.”
Rather than treating ECM as the only option, part of her the coach’s job is helping providers see the entire service menu – Community Health Worker (CHW) services and Community Supports (CS) – and think about how to move a client between them as their needs change. This sometimes requires total reframes for organizations that “have been doing free services for years.”
This is genuinely new territory, managed care plans haven’t worked with small nonprofits at this scale. At Full Circle, we see our providers’ success as our success. Our shared success business model means our financial interests are aligned with our providers.