DHCS Medi-Cal CalAIM: positioning your org for Enhanced Care Management reimbursement

The Strategy

CalAIM (California Advancing and Innovating Medi-Cal) introduced the Enhanced Care Management (ECM) benefit, which reimburses Lead Care Managers (often FQHCs or CBOs) for providing intensive care management to high-need Medi-Cal members. This is the most important sustainability pathway for California health equity orgs right now. The grant strategy: position your grant-funded project as building ECM readiness. You're not asking for ongoing service funding — you're asking for the infrastructure investment (staff training, data systems, care plan templates, member outreach) to become an ECM provider or a sub-contracted ECM support entity. The ECM readiness components funders look for: (1) staff trained in ECM requirements (24/7 access, face-to-face engagement, care plan development), (2) data infrastructure to…