Enhanced Care Management

Enhanced Care Management

Enhanced Care Management FAQ

Enhanced Care Management offers extra services to help you get the care you need to stay healthy. These services have no cost, and you can join or stop at any time. 

ECM may be for IEHP members of any age who:

  • Are homeless with complex health or behavioral health needs
  • Have frequent hospital admissions, short-term skilled nursing facility stays or emergency room visits
  • Have a serious mental illness or substance use disorder with complex social needs
  • Are at risk for institutional long-term care
  • Are nursing facility residents who want to transition into the community
  • Are transitioning from incarceration with complex health or mental health needs, substance use disorder, brain injury, or HIV
  • Have complex physical, behavioral, or developmental health needs
  • Are currently pregnant or within 12 months after giving birth

ECM does not change any of your benefits. You keep your providers and get help to:

    • Find doctors and get appointments for all health needs
    • Improve your health by working with you and your doctor on your care plan
    • Arrange transportation to doctor visits
    • Get follow-up services after you leave the hospital
    • Manage your medicines
    • Connect to local resources such as food or other social services
    • Nurse care manager
    • Behavioral health care manager
    • Care Coordinator
    • Community health worker

Your care team helps you set up no-cost services like primary care, mental health, community-based long-term services and supports, developmental health, oral health, and social services. They can support you by phone or in person and may even go to your location.

Enhanced Care Management FAQ

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Enhanced Care Management offers extra services to help you get the care you need to stay healthy. These services have no cost, and you can join or stop at any time.

 

IEHP Enhanced Care Management (ECM) is a no-cost Medi-Cal benefit that addresses the clinical and non-clinical needs of high-need, high-cost IEHP Members through systematic coordination of services and comprehensive care management. ECM is a collaborative and interdisciplinary approach to providing intensive and comprehensive care management services to individuals.

ECM may be for IEHP members of any age who:

  • Are homeless with complex health or behavioral health needs
  • Have frequent hospital admissions, short-term skilled nursing facility stays or emergency room visits
  • Have a serious mental illness or substance use disorder with complex social needs
  • Are at risk for institutional long-term care
  • Are nursing facility residents who want to transition into the community
  • Are transitioning from incarceration with complex health or mental health needs, substance use disorder, brain injury, or HIV
  • Have complex physical, behavioral, or developmental health needs
  • Are currently pregnant or within 12 months after giving birth

ECM does not change any of your benefits. You keep your providers and get help to:

    • Find doctors and get appointments for all health needs
    • Improve your health by working with you and your doctor on your care plan
    • Arrange transportation to doctor visits
    • Get follow-up services after you leave the hospital
    • Manage your medicines
    • Connect to local resources such as food or other social services
    • Nurse care manager
    • Behavioral health care manager
    • Care Coordinator
    • Community health worker

Your care team helps you set up no-cost services like primary care, mental health, community-based long-term services and supports, developmental health, oral health, and social services. They can support you by phone or in person and may even go to your location.

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