Enhanced Care Management, also called ECM, is a Medi-Cal benefit. It helps people with complex health or social needs get extra support to manage their care. ECM provides services like care coordination, help connecting to community resources, and support to reach personal health goals. This benefit is designed for individuals who may need more help than usual to stay healthy and safe, such as people living with serious mental health needs, people experiencing homelessness, or people with multiple long-term health conditions.

The goal of ECM is to give each person more consistent, personalized care and to connect them to services that improve their health and well-being.

When you provide ECM, you become a trusted partner to the member. You work together to understand what matters most to them and help them take steps toward their goals.

Organizations that provide Enhanced Care Management services can use Pear Suite to support their work. In Pear Suite, you can import member information files from the health plans your organization works with so that your team can outreach to those members and offer your services.

You can use Pear Suite to document and bill for your outreach efforts.  Each time you meet with or talk to a member, you can document and create claims for your encounters. Pear Suite gives you a place to create care plans that show each member’s goals and the steps you are taking together to reach them.

If you have documents or forms related to a member, you can upload these files directly to the member’s profile so everything stays in one place. Pear Suite also allows you to export reports your organization may need to meet the requirements of the contracts you have with health plans.

By using Pear Suite for these tasks, your organization can stay organized, keep complete records, and show the value of the care you are providing.

Enhanced Care Management Resources

CALAIM Enhanced Care Management Policy Guide

ECM Policy Guide-DHCS

ECM Provider Toolkit-DHCS