Enhanced Care Management

Enhanced Care Management (ECM) is a Medi-Cal care management benefit. ECM offers extra services to members with complex needs that make it difficult to improve their health. This could include health conditions or challenges such as not having a place to live.

Working with an ECM care team

Qualified members who enroll in ECM are paired with a care team. The care team works with the member to make a care plan. This can include connecting members with core community and social services.

Who can get ECM?

Members must be enrolled in a Medi-Cal managed care health plan. They must meet eligibility requirements to receive ECM services. If they qualify, using ECM services is their choice.

People who qualify

ECM is for Medi-Cal members with the most complex medical and social needs. It is available to select “Populations of Focus”. It will address the clinical and non-clinical needs of the highest-need members. Members will be picked with the help of health and health-related services.

How to request ECM?

You can talk to your doctor or call Blue Shield Promise Customer Care. They can help check if you qualify for ECM services.

Blue Shield Promise offers the following ECM to eligible Medi-Cal members in Los Angeles and San Diego counties:

Enhanced Care Management Populations of Focus
Adults and their families experiencing homelessness Adults at risk for avoidable hospital or emergency department (ED) utilization (formerly “High Utilizers”)
Adults with serious mental health or substance use disorder (SUD) needs Individuals transitioning from incarceration
Adults with intellectual or developmental disabilities (I/DD) Pregnant or postpartum adults
Adults living in the community and at risk for Long Term Care (LTC) Institutionalization Adult nursing facility residents transitioning to the community
Effective July 1, 2023
Adults without dependent children/youth living with them experiencing homelessness

Children and youth:

  • Homeless families or unaccompanied children/youth experiencing homelessness
  • Children and youth at risk for avoidable hospital or ED utilization
  • Children and youth with serious mental health and/or SUD needs
  • Children and youth enrolled in California Children’s Services (CCS) or CCS Whole Child Model (WCM) with additional needs beyond the CCS condition
  • Children and youth involved in child welfare
  • Children and youth with intellectual or developmental disabilities (I/DD)
  • Pregnant or postpartum youth
Effective January 1, 2024
Pregnant or postpartum youth and adults in racial and ethnic groups experiencing disparities in care for maternal morbidity and mortality

 

Visit the Department of Health Care Services for more information.

For healthcare providers, visit the Provider Connection Portal.

Extra services Blue Shield Promise offers

Community Supports are extra services that are offered to eligible members. Visit the Community Supports page to find out if you’re eligible.

Go to Community Supports

Last updated: 07/07/2023
Medi_23_150_LS_IA062323

醫療保健方案處：1-844-580-7272，週一至週五上午8點至下午6點。 聽障和語障用戶應致電1-800-430-7077。

有關 Blue Shield Promise Cal MediConnect Plan和您的醫療保健的其他 Cal MediConnect選項的資訊，請致電醫療保健服務部1-800-430-4263（聽障和語障專線：1-800-735-2922）或訪問 https://www.healthcareoptions.dhcs.ca.gov/.

Blue Shield of California Promise Health Plan是一家管理式護理組織，由Blue Shield of California全資擁有，提供Medi-Cal和Cal MediConnect 計劃。

© 2002-2023. 年California Physicians’ Service DBA Blue Shield of California Promise Health Plan版權所有。保留所有權利。

California Physicians’ Service DBA Blue Shield of California Promise Health Plan是Blue Shield Association的獨立持照者。

醫療網可能隨時更改。必要時會通知您。

Blue Shield of California Promise Health Plan遵守相關的州和聯邦民權法律規定，不會因為種族、膚色、民族起源、祖先、宗教、性別、婚姻狀態、性別認同、性傾向、年齡或殘障而歧視任何人。

Blue Shield of California Promise Health Plan cumple con las leyes estatales y las leyes federales de derechos civiles vigentes, y no discrimina por motivos de raza, color, país de origen, ascedencial, religión, sexo, estado civil, genero, identidad de genero, orientación sexual, edad ni discapacidad.

Blue Shield of California Promise Health Plan 遵循適用的州法律和聯邦公民權利法律，並且不以種族、膚色、原國籍、血統、宗教、性別、婚姻 狀況、性別認同、性取向、年齡或殘障為由而進行歧視。

Translate

 

Blue Shield of California Promise Health Plan, 3840 Kilroy Airport Way, Long Beach, CA  90806

Apple 和 Apple標誌是Apple Inc.的商標。App Store是Apple Inc.的服務標誌。

Google Play和Google Play標誌是Google LLC的商標。

TRUSTe