Enhanced Care Management Services
Email: inpsire@calvoices.org | Phone: (916) 234-0193
This free service is exclusively available to Anthem Blue Cross members in
Alpine, Amador, Calaveras, El Dorado, and Sacramento Counties.
What is Enhanced Care Management?
Enhanced Care Management (ECM) is a benefit for eligible Medi-Cal Managed Care (Medi-Cal) members with complex health and/or social needs. ECM provides a whole-person approach to care that addresses the clinical and non-clinical circumstances of a high-need Medi-Cal member and is a collaborative approach to providing intensive and comprehensive care management services to individuals.
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ECM gives qualified members extra services from a dedicated ECM provider
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A lead care manager, who works for the ECM provider, coordinates the member’s health care services and links them to community and social services.
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The member’s ECM provider works with all of their providers to give an added layer of support.
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Members get these extra services at no cost as part of their Medi-Cal benefits.
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ECM will not take away any of the member’s current Medi-Cal benefits.
Services Offered:
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Enrolling in Medi-Cal
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Understanding your prescription drugs
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Support with finding and keeping housing
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Finding doctors and making appointments
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Connection to local resources and services
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Help with accessing mental health or substance use care
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Getting follow-up services after you leave the hospital
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Setting up transportation to your doctor visits
Populations Focus
Cal Voices INSPIRE Program serves the following Populations of Focus (PoF):
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Adults, families, and unaccompanied minors experiencing homelessness
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Adults, children, and youth at risk for avoidable hospital or emergency department utilization
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Adults, children, and youth with serious mental health and/or substance use disorder needs
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Adults, children, and youth transitioning from incarceration
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Children and youth involved in child welfare
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Children and youth enrolled in California Children’s Services (CCS)
Verify our Program
You can verify that this is a legitimate program offered through Anthem Blue Cross by
Contacting Anthem’s Customer Care Center at 1-800-407-4627 for verification inquiries.
Learn more about ECM on the Anthem website.
Eligibility
To be eligible for ECM services, all of the following must apply:
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Be enrolled in a Medi-Cal
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Be enrolled in Anthem Blue Cross
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Meet at least one of the Populations of Focus (see above)
*Other eligibility criteria and exclusions may apply
Referral Process
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Identify an eligible member: Someone recognizes a Medi-Cal member with complex needs (e.g., housing instability, serious mental illness, frequent hospital use).
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Submit referral: The referral form is completed and transmitted to the INSPIRE Program.
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Eligibility check: The INSPIRE Program and Managed Care Plan (Anthem) confirms the member meets ECM criteria, including being in a "Population of Focus".
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Provider assignment: If eligible, the Managed Care Plan (Anthem) assigns the member to the INPIRE Program or other ECM provider for care coordination, if appropriate.
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INSPIRE Program staff member will contact the referred member to inform them of the outcome of their referral, including whether it has been authorized, declined, or if additional information is required.
Documentation Requirements
To help expedite the referral process, we encourage referring parties to submit any relevant supporting documentation alongside the referral form. We will review community referrals and use available data to confirm the individual’s eligibility for ECM. If additional information is needed to complete the review and approval, we will reach out for additional information and/or documentation. View a list of supporting documentation here.
Who can submit a referral?
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Healthcare providers
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Social service providers
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Community Agencies
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Other ECM providers
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Managed Care Plans (MCPs)
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Medi-Cal members and their families
Enroll Today!
Need help completing the form?
Call us at (916) 234-0193 or email inspire@calvoices.org.
CONTACT INFORMATION
(916) 234-0195
(916) 855-5448
Hours of Operation
Monday - Friday
8:30 AM - 4:30 PM
The INSPIRE (Enhanced Care Management) Program is made possible through a strategic partnership between Cal Voices and Anthem Blue Cross, supported by CalAIM (California Advancing and Innovating Medi-Cal).
