Enhanced
Care Management

Enhanced Care Management provides
7 core services

Outreach and engagement
Comprehensive assessment and care management plan
Enhanced coordination of care
Health promotion
Comprehensive transitional care
Member and family supports
Coordination of and referral to community and social support services

What will I gain as a member of Enhanced Care Management?

You will have a personalized care team – including a Care Manager – that works together to help you get the care you need.

Your care team and Care Manager will work with you to develop an individualized Health Action Plan. A Health Action Plan will help you to meet your goals and objectives in hopes of better overall health and wellness.

You receive extra services at no cost as part of your Medi-Cal benefits, including help with:

Making and following-through with appointments
Transportation to-and-from doctors’ appointments (coordination of insurance provided
transportation services)
Understanding your prescription medications
Medication reminders
Coordination of Specialty referrals and visits
Getting follow-up services after you leave the hospital
Connecting to and applying for community programs and services

Who qualifies for Enhanced Care Management?

To be eligible for Enhanced Care Management services, individuals must be enrolled in a Medi-Cal Health Plan (Elica Health Centers are contracted to provide Enhanced Care Management Services in the Sacramento County to Molina, Health Net and Anthem Blue Cross Members; and to Partnership Health Plan members in Yolo and Placer Counties), and meet criteria for 1 of 3 current Populations of Focus as indicated below:

Adult (21 and older) experiencing homelessness/unstable housing AND have at least one complex physical, behavioral, or developmental health need;
or
Child or Youth (0–20 years old) experiencing homelessness/unstable housing.
Adult (21 and older) high utilizers who in the last 6 months have had 5+ ER visits OR 3+ unplanned hospital admissions OR 3+ short-term SNF stays;
or
Child or Youth (0–20 years old) who in the last 12 months have had 3+ ER visits OR 2+ unplanned hospital admissions OR 2+ short-term SNF stays.
Adult (21 and older) with serious mental illness or substance use disorder and other health needs AND at risk of institutionalization OR experiencing a complex social factor affecting their health;
or
Child or Youth (0–20 years old) with serious mental illness or substance use disorder and other health needs.

How can I receive additional information?

For more general information regarding the Enhanced Care Management Program, please view the Member Toolkit.

For more information regarding Elica's Enhanced Care Management Program, please contact ecm@elicahealth.org.

You may also inquire about a referral by calling your health plan or asking your Elica primary care provider to submit a referral to the Care Coordination team.

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Open Payments Information

For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public.

The Open Payments database is a federal tool used to search payments made by drug and device companies to physicians and teaching hospitals. It can be found at https://openpaymentsdata.cms.gov