CBHA - Enhanced Care Management and Community Supports Learning Collaborative

The purpose of this survey is to empower organizations through a structured learning environment focused on enhancing digital infrastructure for Enhanced Care Management (ECM) and Community Supports (CS) services under CalAIM.

In the face of workforce shortages and financial sustainability challenges, leveraging digital tools is essential. Enhanced digital infrastructure enables providers to streamline workflows, reduce administrative burdens, and improve data accuracy. For ECM - due to the volume of clients needed for financial viability of the program at an organizational level - it is critical for staff to have tools to effectively intake referrals and track the volume of outreach, qualification, and care management activities.  Streamlining and automating these efforts builds the capacity for each team member to deliver more client-centered care. Efficient data handling and reporting are crucial for timely reimbursements and demonstrating program effectiveness, vital for the financial viability of ECM and CS services. 

Key focus areas:

  • Streamlining information sharing: Optimize how you collect and share client information when coordinating care to reduce paperwork and ensure everyone involved has the necessary details promptly.
  • Organizing and protecting data: Implement straightforward systems to keep client information organized and secure, making it easier for staff to access what they need without delays.
  • Simplifying reporting: Make it easier to track and report on services provided, helping demonstrate the impact of your work and meet funding requirements.
  • Connecting systems: Ensure your tools and systems work well with those of your partners, like health plans and other providers, to coordinate care effectively.
  • Improving billing processes: Simplify billing procedures to ensure timely payments, reducing financial strain and allowing your team to focus more on client care.


Address common challenges faced by ECM/CS providers: 

  • Fragmented data exchange: Working with multiple MCPs, each having distinct data exchange protocols, complicates the submission of service data and invoices, leading to increased administrative burdens.
  • Complex billing processes: Requirements to submit compliant claims or standardized invoices can be daunting, especially for organizations lacking robust billing infrastructure, resulting in delayed reimbursements and cash flow issues.
  • Inconsistent reporting requirements: Variations in reporting expectations across MCPs can lead to confusion and inefficiencies. Community-based organizations (CBOs) may struggle to meet diverse data submission standards, affecting your ability to demonstrate service delivery and outcomes effectively.
  • Limited technical capacity: Many CBOs lack the necessary technical infrastructure or expertise to manage electronic health records (EHRs), data analytics, and secure data sharing, hindering their ability to participate fully in CalAIM initiatives.


Approach:

This collaborative learning approach brings together participants in region, county, or MCP-based cohorts for interactive workshops that unpack the essential components of ECM/CS service delivery, such as:

  • Member information file management, outreach attempt tracking, referral management
  • Client intake and eligibility verification
  • Care planning and coordination
  • Closed-loop referral and linkage management
  • Program oversight, reporting, and auditing
  • Billing and reimbursement
  • Data exchange with systems (MCP, HIE, EHR)

Expected outcomes:

  • Identify core digital infrastructure needs and gaps within each cohort
  • Develop actionable strategies to address these gaps
  • Explore appropriate funding sources for solution development
Fields marked with an * are required.

Please verify that you have checked the “I'm not a robot” checkbox.

Is your organization currently contracted with a Medi-Cal Managed Care Plan (MCP) to provide Enhanced Care Management (ECM) and/or Community Supports (CS) services?

Please list the Medi-Cal Managed Care Plan(s) (MCPs) with which your organization is currently contracted or in the process of contracting for ECM and/or CS services.

In which California county or counties does your organization currently provide, or plan to provide, ECM and/or CS services?

What are the primary challenges your organization faces in data flow, handling, and reporting for ECM and CS services?

Member information file management, outreach attempt tracking, referral management
Client intake and eligibility verification
Care planning and coordination
Closed-loop referral and linkage management
Program oversight, reporting, and auditing
Billing and reimbursement
Data exchange with systems (MCP, HIE, EHR)
Other