ECM Basics
This is the primary goal of ECM: reducing avoidable ___ and improving health outcomes.
What is utilization?
This service ensures members attend medical, behavioral, and social appointments.
What is care coordination?
All ECM encounters must be documented within this timeframe
What is 24 hours?
ECM must contact members within this timeframe after hospital discharge.
What is 2 Business Days?
ECM is a statewide benefit under this California program.
This service includes advocating for members across systems to ensure they receive timely, appropriate services.
What is member advocacy?
This structured communication tool helps ECM staff clearly relay member updates to providers.
What is SBAR?
This document from the hospital provides diagnoses, treatment, and follow‑up instructions.
What is the discharge summary?
This term describes the comprehensive, whole‑person approach ECM uses to address medical, behavioral, and social needs.
What is person‑centered care?
This ECM activity ensures the member’s goals, strengths, and preferences guide all interventions
What is person‑centered planning?
This required document must be updated every 90 days or when member needs change.
What is the care plan?
This type of follow‑up appointment is prioritized within 7 Days post‑discharge.
What is a PCP or specialist follow‑up?
This statewide initiative integrates ECM, Community Supports, and payment reform.
What is CalAIM?
This service includes coaching members on medication adherence, chronic disease management, and health literacy.
What is health education?
This SBAR section includes relevant history, recent events, and clinical or social context.
What is the Background?
This ECM activity ensures medication changes are understood after discharge.
What is medication reconciliation?
This is the required document that outlines goals, interventions, and member‑identified priorities.
What is the care plan?
This service involves identifying and addressing barriers like transportation, literacy, or technology access.
What is reducing social determinants of health barriers?
This federal law protects member privacy and governs how PHI is handled.
What is HIPAA?
This high‑risk transition requires coordination between jail/prison staff, health plans, and ECM providers.
What is re‑entry planning?