Enhanced Care Management

About the Program

Category: Human Services (Best in Category)

Year: 2023

Enhanced Care Management (ECM) is a clinical service delivery model that focuses on providing individualized, whole-person care by a trained, integrated care team that works in close connection with the Member’s Primary Care Provider (PCP) and all other network providers. This integrated care team, known as the Community- Based Care Management Entity (CB-CME) provides an intensive set of services for a small subset of Medi-Cal beneficiaries that meet the criteria for enrollment in the Enhanced Care Management. The ECM focuses on whole-person, complex care management, which includes changing behaviors and patterns of health care among both Providers and Members. The Goal of the ECM is to reduce avoidable, high-cost interventions and increase the use of appropriate, timely interventions, along with improved self-care management. ECM staff meets beneficiaries wherever they are – on the street, in a shelter, in their doctor's office, or at home. ECM coordinates care and services among the physical, behavioral, dental, developmental, and social services delivery systems, making it easier for beneficiaries to get the right care at the right time.