State of California

Enhanced Care Management: Community Support Utilization

Name: Enhanced Care Management: Community Support Utilization
Creator: State of California

ECM Community Support Services tables for a Quarterly Implementation Report. Including the County and Plan Details for both ECM and Community Support. This Medi-Cal Enhanced Care Management (ECM) an... Maintained by the State of California.

Example records

Namelegal entity	Cityaddress	Objectididentifier	Last Date In The Reporting Peritemporal	County Hhp Wpc Status status	Number Of Community Support Serquantity	Average Mcp Members In The Lastquantity	Number Of Members Who Utilized quantity	Number Of Community Supports Sequantity	Rate Of Community Supports Servquantity
Partnership Health Plan of California	Yuba	118	03/31/2025	N	9	35988	1178	2203	612
Kaiser Permanente	Yuba	117	03/31/2025	N	13	698	*	*	*
Partnership Health Plan of California	Yolo	116	03/31/2025	N	9	52981	586	1077	203

Use cases

Managed Care Plan Market Sizing for Healthcare Vendors

A health tech company evaluating which Medi-Cal managed care plans to target for a community support software contract analyzes enrolled member counts and service utilization rates by plan and county to prioritize outreach toward plans with high volume but lower service delivery rates, indicating unmet operational need.

NameCityAverage Mcp Members In The LastNumber Of Members Who Utilized Rate Of Community Supports Serv

Counterparty Due Diligence on Medi-Cal Plan Partners

A specialty pharmacy or home health agency entering a subcontract with a Medi-Cal managed care plan reviews the plan's community support service volume and county footprint to assess operational scale and whether the plan has an active, functioning ECM program before committing to a partnership.

NameCityNumber Of Community Support SerNumber Of Community Supports SeLast Date In The Reporting Peri

Fraud and Billing Anomaly Screening for Community Support Claims

A Medicaid fraud analytics team flags managed care plans where reported service delivery counts are disproportionately high relative to average enrolled membership, using the utilization rate as a signal to prioritize audit referrals for plans whose per-member service ratios fall outside expected ranges.

NameAverage Mcp Members In The LastNumber Of Members Who Utilized Rate Of Community Supports ServLast Date In The Reporting Peri