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
- Discussion Questions
- Presentation Materials (presented by Drs. Takashi Wada and Elise Pomerance, Inland Empire Health Plan)
- Meeting Summary
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Session 2: Development of the ECM & ILOS Model of Care
Meeting Resources
- Discussion Questions
- Presentation Materials (presented by Dr. Fiona Donald and Lindsay Petersen, San Francisco Health Plan)
- Meeting Summary
Shared Plan Resources
Provided by San Francisco Health Plan
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Session 3: ECM & ILOS — Provider-Related Issues & Considerations
Meeting Resources
- Discussion Questions
- Presentation Materials (presented by Alison Klurfeld and Mary Zavala, L.A. Care Health Plan)
- Meeting Summary
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
- Discussion Questions
- Presentation Materials (presented by Amy Scribner, Health Plan of San Mateo)
- Meeting Summary
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 6-9
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
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Session 8: Process for Receiving & Approving Referrals for ECM and ILOS Services
Meeting Resources
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Session 9: Finalizing Model of Care Part 2 Submission
Meeting Resources