The Department of Health Care Services recently launched the CalAIM initiative, which stands for California Advancing and Innovating Medi-Cal. CalAIM proposes a framework to guide upcoming Medicaid transformation initiatives, including waiver renewals, as the state’s current 1115 waiver (Medi-Cal 2020) and 1915(b) waiver come to a close in 2020. CalAIM provides an opportunity for policymakers and stakeholders to build on progress to date to make the health care delivery system more efficient and effective for people who rely on Medi-Cal.