DHCS Reports CalAIM ECM Up 59% Year-Over-Year, Then Proposes Utilization 'Refinements' Saving $184M in 2026-27, Growing to Over $530M/Year by 2029-30

DHCS's June 26, 2026 quarterly update shows Enhanced Care Management served nearly 227,500 members in Q3 2025 — up 59% from Q3 2024, with nearly 453,000 members served since 2022 — even as a May 2026 DHCS fact sheet ('Refinements and Efficiencies for Community Supports and ECM') proposes utilization-management changes to both programs.

The fact sheet cites that ECM members have been receiving fewer than 2 ECM services per month, below the 3+ services consistent with appropriate ECM care models, and proposes constraining referral sources (including prohibiting authorization requests directly from Community Supports providers for services like asthma remediation and medically tailored meals), limiting housing-service eligibility beyond an initial six-month period, tightening authorizations that overlap IHSS, and adding graduation/duration criteria.

Projected savings: $111.8 million ($41.4M General Fund) in 2026-27 for ECM, rising to $394.4 million ($145.9M GF) in 2029-30 and ongoing, plus $72.5 million ($26.9M GF) in 2026-27 for Community Supports, rising to $137.8 million ($51.0M GF) ongoing — a combined ~$532M/year at maturity. FQHCs and community partners billing these CalAIM services face tighter referral, duration, and payment rules even as demand hits record highs.