Enhanced Care Management (ECM) is a statewide Medi-Cal benefit effective January 1, 2022. ECM aims to provide a whole-person approach to care that addresses the clinical and non-clinical circumstances of high-need members enrolled in Medi-Cal managed care.
The overall goal of the ECM benefit is to provide comprehensive care and achieve better health outcomes for the highest need beneficiaries in Medi-Cal by:
- Improving care coordination
- Integrating services
- Facilitating community resources
- Addressing social determinants of health
- Improving health outcomes
- Decreasing inappropriate utilization and duplication of services
For additional information from Department of Health Care Services (DHCS) on ECM, refer to their website.
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Eligibility
Medi-Cal managed care members are eligible for the ECM benefit if they meet specific eligibility criteria of a population of focus.
Seven Core Services
ECM providers deliver core service components of intensive and comprehensive care management to members enrolled in the program.
Referring Members to ECM
Eligible members may be referred to ECM by a provider, case manager, or other professionals already serving the population of focus.
Enhanced Care Management Providers
Enhanced Care Management (ECM) is delivered primarily by community-based entities that hold contracts with managed care plans (MCPs).
FAQs and Resources
L.A. County managed care plans developed a set of Frequently Asked Questions to support new ECM Providers. We've also got webinars slides about the program.