Members

Enhanced Care Management (ECM)

Molina Healthcare covers Enhanced Care Management (ECM) services for members with highly complex needs. ECM is a benefit that provides extra services to help you get the care you need to stay healthy. It coordinates the care you get from different doctors. ECM helps coordinate primary care, acute care, behavioral health, developmental, oral health, community-based long-term services and supports (LTSS), and referrals to available community resources. 

If you qualify, you may be contacted about ECM services. You can also call Molina Healthcare to find out if and when you can receive ECM. Or talk to your health care provider who can find out if you qualify for ECM and when and how you can receive it. 

Covered ECM services:

If you qualify for ECM, you will have your own care team, including a Lead Care Manager (LCM). This person will talk to you and your doctors, specialists, pharmacists, case managers, social services providers and others to make sure everyone works together to get you the care you need. The LCM can also help you find and apply for other services in your community. There is no cost to you for ECM services.

Enhanced Care Management Core Services includes: 

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

ECM is designed to assist the following populations of focus:

  • Adults experiencing homelessness (single)
  • Adults with families or unaccompanied children/youth experiencing homelessness
  • Adults at risk for avoidable hospital or emergency department (ED) utilization
  • Adults and children/youth with serious mental health and/or substance use disorder needs (SUD)
  • Adults living in the community and at risk for long-term care institutionalization (LTC)
  • Adult nursing facility residents transitioning to the community
  • Adults and youth transitioning from incarceration
  • Pregnant and postpartum individuals (Birth Equity)
  • Children/youth enrolled in California Children's Services (CCS) with additional needs beyond the CCS condition
  • Children/youth involved in child welfare
  • Children/youth at risk for avoidable hospital or (ED) utilization

Referrals for ECM can be made using the form located on our website under Frequently Used Forms (molinahealthcare.com).

To find out if ECM may be right for you, talk to your health care provider or call Member Services at 1-888-665-4621 (English) (TTY/TDD 711), Monday-Friday 7:00 a.m. - 7:00 p.m. The call is toll free.