Event

CalAIM Learning Collaborative Resources Page
Enhanced Care Management & In Lieu of Services

Welcome to the CalAIM Learning Collaborative resources page. Here you will find helpful information on the collaborative, as well as a collection of resources and reference materials to aid in your planning and implementation. 

Note: Materials shared by plans should not contain protected health information or other identifying information. The resources listed here are intended exclusively for LHPC member plans; please do not share the URL or materials outside of your organizations.

Overview

In anticipation of the Enhanced Care Management (ECM) and In Lieu of Services (ILOS) implementation, the LHPC Institute has developed a learning collaborative to help local plans better understand what’s expected, offer a forum to share and exchange plan practices and approaches, and provide support and resources as work gets underway.

Topics for discussion include:

  • Crosswalking WPC to ECM or ILOS and HHP to ECM 
  • Model of Care 
  • Developing ECM provider ratios and network adequacy standards
  • Considerations for determining whether to offer ILOS
  • Credentialing for ECM and ILOS providers
  • ECM/ILOS authorizations
  • Obtaining and managing member consent
  • ECM, CCM and NQCA

Meeting Resources — Sessions 1-5

Session 1: ECM/ILOS Transition Planning — WPC/HHP Crosswalk & County Contracting Strategies

Meeting Resources

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Session 2: Development of the ECM & ILOS Model of Care

Meeting Resources

Shared Plan Resources
Provided by San Francisco Health Plan 

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Session 3: ECM & ILOS — Provider-Related Issues & Considerations 

Meeting Resources

Shared Plan Resources
Provided by L.A. Care Health Plan

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Session 4: Considerations for Determining Whether to Offer ILOS

Meeting Resources

Shared Plan Resources
Provided by Partnership HealthPlan of California

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Session 5: Finalizing Model of Care Submission

Meeting Resources

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Meeting Resources — Sessions 6 & 7

Session 6: Vetting Qualifications of Non-Traditional Providers Without a State-Level Enrollment Pathway

Meeting Resources

Shared Plan Resources

Provided by Santa Clara Family Health Plan

Provided by Central California Alliance for Health

Provided by Inland Empire Health Plan

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Session 7: Vetting Qualifications of Non-Traditional Providers Without a State-Level Enrollment Pathway (cont.)

Meeting Resources