Healthcare in California is evolving to become more inclusive, equitable, and supportive, especially for individuals and families who face complex challenges. At the forefront of this change is Enhanced Care Management (ECM), a person-centered approach designed to address not just medical needs, but also the social and environmental factors that influence health.
ECM is part of California’s broader Medi-Cal transformation under the CalAIM (California Advancing and Innovating Medi-Cal) initiative. Its goal is to improve health outcomes for vulnerable populations by coordinating care across services, medical, behavioral, and community-based. Whether it’s helping someone manage multiple chronic conditions or supporting a pregnant mother with housing instability, ECM connects individuals to the services they need most.
In this blog, we’ll explore what Enhanced Care Management means in practice, who it serves, and how programs like Inland Empire ECM Riverside and others are making a difference, especially in maternal and family health.
What Is Enhanced Care Management?
Enhanced Care Management is a Medi-Cal benefit that offers intensive, personalized care coordination for individuals with complex health and social needs. It’s not just about healthcare, it’s about whole-person care.
Through ECM, eligible individuals are paired with a care team that helps them navigate the healthcare system, access community resources, and achieve better health outcomes. Services are provided by a lead care manager who serves as the central point of contact and works with the individual to develop a personalized care plan.
This includes assistance with:
- Scheduling medical appointments
- Managing medications
- Coordinating specialists and follow-ups
- Securing transportation
- Accessing food, housing, or behavioral health services
- Advocating for the individual within various systems
Who Benefits from ECM?
ECM is designed for Medi-Cal members who fall into certain high-need categories, including:
- Individuals experiencing homelessness
- Adults and children with serious mental illness or substance use disorders
- Those with complex medical conditions
- Foster youth or those transitioning out of foster care
- People recently released from incarceration
- Pregnant and postpartum individuals facing medical, social, or housing challenges
The inclusion of prenatal and postpartum populations is particularly important for addressing systemic health disparities and improving family wellness across the state.
Supporting Families Through Prenatal and Postnatal Care
One of the most impactful applications of Enhanced Care Management is in prenatal and postnatal care. Expectant mothers often face a mix of physical, emotional, and social challenges that can affect their health and the health of their babies. ECM helps bridge gaps in care by:
- Ensuring early and consistent prenatal checkups
- Coordinating care across OB-GYNs, doulas, and specialists
- Connecting mothers to nutritional assistance, parenting education, and lactation support
- Addressing non-medical barriers like transportation, housing, or domestic safety
By integrating medical care with social services, ECM empowers mothers to have safer pregnancies, healthier births, and stronger postpartum recoveries.
How Inland Empire Health Plan Is Leading the Way
In Southern California, the Inland Empire Health Plan (IEHP) has been a trailblazer in implementing ECM. Serving over 1.5 million residents across Riverside and San Bernardino counties, IEHP collaborates with local providers, clinics, and community-based organizations to deliver enhanced care where it’s needed most.
IEHP’s ECM program has prioritized maternal and child health, mental health, and chronic disease management, helping ensure that no one falls through the cracks. Through their efforts, more families have access to personalized care plans, culturally sensitive support, and consistent check-ins from care coordinators who understand their community.
Inland Empire Birth Equity: A Critical Piece of the Puzzle
Equity in healthcare means every person has a fair opportunity to achieve their best health. In maternal care, this means addressing the deep-rooted disparities in outcomes experienced by Black, Indigenous, and other women of color.
Inland Empire Birth Equity initiatives aim to close these gaps by advocating for respectful, culturally competent maternal care across the region. These initiatives align closely with ECM’s mission by:
- Providing implicit bias training to care providers
- Elevating the voices of mothers and birth workers of color
- Expanding access to doulas, midwives, and community support programs
- Supporting Black maternal mental health awareness campaigns
When ECM incorporates these equity-driven practices, it doesn’t just coordinate care, it transforms it.
Spotlight: Inland Empire ECM Riverside
The Inland Empire ECM Riverside program offers a clear example of what effective Enhanced Care Management looks like on the ground. Serving a diverse population with high needs, this program focuses on personalized, trauma-informed care coordination for Medi-Cal members in Riverside County.
Care managers in the Riverside program are trained to identify and respond to the layered challenges families may face, from chronic illness and behavioral health struggles to food insecurity and unstable housing. For pregnant and parenting individuals, this means a more seamless connection to prenatal care providers, early intervention programs, parenting classes, and even basic needs like diapers and safe sleep spaces.
What makes ECM unique in Riverside is its strong network of community-based partners, ensuring that care goes beyond the clinic and into the environments where people live, work, and raise their families.
The Future of Enhanced Care in California
As ECM expands across the state, California’s healthcare system is being reshaped to focus on person-centered, equitable, and integrated care. This transformation reflects a growing understanding that medical care alone cannot fix health disparities; social conditions must also be addressed.
Moving forward, we can expect to see:
- Greater investment in community health workers and peer navigators
- More collaboration between health systems and grassroots organizations
- Broader use of digital tools to support remote monitoring and care coordination
- Expansion of ECM to more Medi-Cal populations, including youth and seniors
For families, this means more accessible, continuous care across all stages of life, from pregnancy and early childhood to adulthood and aging.
Final Thoughts
Enhanced Care Management represents a transformative shift in how California delivers healthcare, placing individuals, families, and communities at the center of care. By addressing the root causes of poor health, like housing, transportation, and access to consistent care, ECM helps create real, lasting change in people’s lives.
Whether it’s helping a mother get timely prenatal checkups or connecting a senior with behavioral health support, this approach ensures no one is left to navigate complex systems alone. With the support of local programs and community partners, California is laying the groundwork for a more connected, equitable, and compassionate healthcare future.
