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Enhanced Care Management

Enhanced Care Management (ECM) is a benefit for CenCal Health members with complex needs. If you qualify for ECM, you’ll have a care manager who will work closely with you, your doctors, and your care team to make sure you get the right care. Your care manager can also connect you to extra services to help you stay healthy – at no cost to you.

Benefits

Care Management

ECM provides members with a dedicated care manager. They can help coordinate all the different parts of their care. This includes help with medical, behavioral health, dental, and social services.

Personal Support

Many Medi-Cal members have complex health needs that involve multiple providers or systems. ECM ensures everyone works together to coordinate care.

Whole-Person Care

ECM goes beyond traditional healthcare to address social determinants (also called social drivers) of health. These are the non-medical factors that influence overall well-being.

Frequently Asked Questions

The section below is what will be changed in the Member Handbook/ Evidence of Coverage (EOC) soon. Please keep this page for your records until the Member Handbook (EOC) is updated and shared with you.

Enhanced Care Management & Community Supports

We would like to tell you about some new services available through your CenCal Health insurance starting on July 1, 2022.

California seeks to improve the Medi-Cal program for people with complex needs and who are facing difficult life and health circumstances. These new services are focused on providing assistance beyond traditional medical services. They are designed to address social drivers of health (factors in people’s lives that influence their health). Enhanced Care Management and Community Supports are the names of two new, statewide Medi-Cal services.

ECM helps coordinate:

Primary care
Acute care
Behavioral health
Developmental health
Oral health
Community-based long-term services and supports (LTSS)
Referrals to available community resources

If you qualify for ECM, you will be contacted by an ECM provider. This provider may be your PCP office or a government or community agency. The ECM provider will help you enroll in the ECM program and assign you a lead care manager.

This person will coordinate care between:

You
Your doctors
Specialists
Pharmacists
Case managers
Social services providers
Others

They will make sure everyone works together to get you the care you need. The lead care manager can also help you find and apply for other services in your community.

You can also call CenCal Health Member Services at 1-877-814-1861 (TTY/TDD 1-833-556-2560 or 711) to find out if and when you can receive ECM, or talk to your health care provider.

ECM services include:

Outreach and engagement
Comprehensive assessment and care management
Enhanced coordination of care
Health promotion
Comprehensive transitional care
Member and family support services
Coordination and referral to community and social supports (ECM Referral Form – in production)

Download ECM Program Flyer – English

Download ECM Program Flyer – Spanish