Guide for Enhanced Care Management and Their Services

Guide for Enhanced Care Management and Their Services

Enhanced Care Management (ECM) is an innovative Medi-Cal advantage that provides free care management services to qualifying members with intricate problems and requirements that make improving their health difficulties. Enhanced Care Management (ECM) is an advantage that provides members with extremely complicated needs with additional care coordination services.

This new advantage can assist members in receiving the care they require to stay healthy. It could also help to facilitate the treatment they receive from the various providers involved in their care.

Members who qualify for ECM will be assigned their care team, which a care coordinator will lead. This individual will communicate with members, their doctors, mental health providers, experts, pharmacists, case managers, social service agencies, and many others to ensure that

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everybody works together to get members the care they require. They can also assist them in locating and applying for other community services.

The overarching goal of the ECM gain is to provide comprehensive care and improve healthcare outcomes for the most vulnerable Medi-Cal beneficiaries by:      

Improving care conditions Service integration Facilitating access to community resources Focussing on social determinants of health Enhancing health outcomes Reducing inappropriate service utilization and duplication

What will you gain by joining ECM? You will be assigned a personalized care team, including a Lead Care Manager, who will collaborate to ensure you receive the care you require. As well as know about behavioral and mental health treatment. serenehealth.com

Your care team and Lead Care Manager will collaborate with you to create an individualized Care Management Plan (CMP). A CMP will assist you in achieving your goals and objectives to improve your overall health and wellness.

What are the core services provided by Enhanced Care Management?

Enhanced Care Program provides seven core services:       

Participation and outreach Comprehensive assessment and care management plan Improved care coordination Health promotion Comprehensive transitional care Member and family support Referral and coordination of social support and community services

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As part of your Medi-Cal benefits, you get free extra services, such as help with:       

Making and keeping appointments Transportation to and from doctor’s appointments Understanding your prescription medications Medication reminders Remote patient monitoring Follow-up care after being discharged from the hospital Connecting with and applying for community programs and services, such as food stamps and housing.

Enhanced Care program will discuss the clinical and non-clinical needs of vulnerable enrollees through strenuous coordination of health and health-related services. Enrollees will be met wherever they are – on the street, in a shelter, at their doctor’s office, or home. Enrollees will also have access to Community Supports to meet their social needs, such as medically supportive foods or housing support.

Enrollees will be assigned a single Enhanced Care Manager who will coordinate care and services across the physical, behavioural, dental, developmental, and social service delivery systems, making it easier for them to receive the appropriate care at the appropriate time.

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