IEHP 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 and others involved in your care. At IEHP, we understand that certain health conditions like diabetes, hypertension, or substance use disorder can be complex, confusing and hard to manage. IEHP’s ECM offers supportive services to address your whole health - to care for your body and mind. You may qualify for ECM with IEHP if you meet certain criteria shown below and need more help with managing your health.
New Benefit!
Enhanced Care Management (ECM)
Who is eligible?
The IEHP ECM is for members who have:
ECM Populations of Focus
Adults |
Children & Youth | ||
1a | Individuals Experiencing Homelessness: Adults without Dependent Children/Youth Living with Them Experiencing Homelessness | X |
|
1b | Individuals Experiencing Homelessness: Homeless Families or Unaccompanied Children/Youth Experiencing Homelessness | X | X |
2 | Individuals At Risk for Avoidable Hospital or ED Utilization (Formerly “High Utilizers” | X | X |
3 | Individuals with Serious Mental Health and/or SUD Needs | X | X |
4 | Individuals Transitioning from Incarceration | X | X |
5 | Adults Living in the Community and At Risk for LTC Institutionalization | X |
|
6 | Adult Nursing Facility Residents Transitioning to the Community | X |
|
7 | Children and Youth Enrolled in CCS or CCS WCM with Additional Needs Beyond the CCS Condition |
| X |
8 | Children and Youth Involved in Child Welfare |
| X |
9 | Pregnant and Postpartum Individuals; Birth Equity Population of Focus | X | X |
If you qualify for ECM, you will have your own care team with a lead care manager that coordinates no-cost services, such as primary care, behavioral health, community-based long-term services and supports (LTSS), developmental health, oral health and social services.
Who is on your care team?
- Nurse Care Manager
- Behavioral Health Care Manager
- Care Coordinator
- Community Health Worker
What IEHP’s ECM includes
If you join ECM, your benefits will not change. You can keep your doctors and providers and your care team will help:
- Find doctors and get an appointment for physical, mental and substance use health needs
- Keep all your providers fully informed
- Set up transportation to your doctor visits
- Get follow-up services after you leave the hospital
- Manage all your medicines
- Connect you to local resources, such as food and other social services
The ECM services are provided at no cost and you can join or stop ECM at any time.
Support when you need it
Your care team can support you by phone or in person and may even go to your location. You are not alone with the IEHP ECM.
To join or stop ECM, call IEHP Member Services at 1-800-440-IEHP (4347). Monday-Friday, 7 a.m.-7 p.m., and Saturday-Sunday, 8 a.m.-5 p.m. TTY users should call 1-800-718-IEHP (4347).
- IEHP Enhanced Care Management Member Brochure - English (PDF) Download IEHP Enhanced Care Management Member Brochure - English (PDF)
- IEHP Enhanced Care Management Member Brochure - Spanish (PDF) Download IEHP Enhanced Care Management Member Brochure - Spanish (PDF)
- IEHP Enhanced Care Management Member Brochure - Chinese (PDF) Download IEHP Enhanced Care Management Member Brochure - Chinese (PDF)
- IEHP Enhanced Care Management Member Brochure - Vietnamese (PDF) Download IEHP Enhanced Care Management Member Brochure - Vietnamese (PDF)
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
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