Enhanced Care Management (ECM) represents a significant benefit within the state-wide Medi-Cal Managed Care Plan, designed to deliver elevated and comprehensive care management for individuals with the most intricate healthcare needs. This Enhanced Care Program strategically assigns a dedicated Lead Care Manager to each member. This manager acts as a central point of contact, expertly guiding them through the complexities of physical, behavioral, and dental health systems.
The primary objective of the ECM benefit is to offer thorough care and achieve improved health outcomes for Medi-Cal beneficiaries with the highest needs. This is accomplished through several key strategies:
- Enhanced care coordination to streamline services.
- Integration of various healthcare services for holistic support.
- Facilitation of access to essential community resources.
- Proactive addressing of social determinants of health that impact well-being.
- Measurable improvements in overall health outcomes.
- Reduction of unnecessary service utilization and duplication, ensuring efficient care delivery.
For more detailed information regarding ECM, please refer to the Department of Health Care Services (DHCS) website. Visit Site
Key Program Information for Members
We provide essential program details that you can readily share with your patients who are members.
Eligibility for the Enhanced Care Program
Medi-Cal managed care members are considered eligible for the Enhanced Care Program benefit if they satisfy specific criteria within a designated population of focus.
Seven Core Services of Enhanced Care Management
ECM providers are committed to delivering seven core service components, focusing on intensive and comprehensive care management for every member enrolled in the Enhanced Care Program.
Referring Members to the Enhanced Care Program
Providers, case managers, and other professionals who are currently serving the population of focus can refer eligible members to the Enhanced Care Program.
Enhanced Care Management Providers
The Enhanced Care Management (ECM) services are primarily provided by community-based organizations that have established contracts with managed care plans (MCPs).
Frequently Asked Questions and Resources
Managed care plans in L.A. County have compiled a comprehensive set of Frequently Asked Questions to assist new ECM Providers. Additionally, webinar slides providing program insights are available.
