Strategy: Build ECM Caseload Now Before Dec 2026 Waiver Expiration, Window Is Closing
With CalAIM's 1115 waiver expiring Dec 2026 and a hostile federal environment for SDOH-focused Medicaid programs, FQHCs must maximize ECM enrollment now. Revenue strategy: (1) Screen every Medi-Cal patient for ECM eligibility (8 populations of focus including homelessness, high ED/hospital utilization, serious MH/SUD, justice-involved).
(2) Layer ECM on grant-funded programs — Ryan White clients on Medi-Cal (not MCWP waiver) can be ECM-enrolled. (3) Cross-train CHWs for both ECM care coordination and Ryan White case management.
(4) Build data infrastructure showing ECM outcomes (reduced ED visits, improved engagement) to justify renewal. (5) Join CPCA and NACHC advocacy for waiver renewal with full ECM/Community Supports authority.
Part of
- CalAIM, Enhanced Care Management and Community Supports
The 1115 waiver renewal · ECM and Community Supports rules
Key points
- Screen every Medi-Cal patient for ECM eligibility — 8 populations of focus including homelessness, high ED/hospital utilization, serious MH/SUD, justice-involved
- Ryan White clients on Medi-Cal (not MCWP waiver) can be ECM-enrolled — layer revenue on grant-funded programs
- Cross-train CHWs for both ECM care coordination and Ryan White case management
- Build data infrastructure showing ECM outcomes (reduced ED visits, improved engagement) to justify waiver renewal
- Join CPCA and NACHC advocacy for waiver renewal with full ECM/Community Supports authority
Sources for this story
DHCS CalAIMSources for your board packet
This story's source plus 4 related stories and their sources, ready to print for your team or board.
Free. Unlocking the packet subscribes you to Intel Brief. You'll be subscribed right away, with no confirmation email. Unsubscribe with one click in any issue. If you unsubscribed before, we won't re-add you. We never sell your email. You can open each source above without an email.
FQHC Talent. (2026, March 4). Strategy: Build ECM Caseload Now Before Dec 2026 Waiver Expiration, Window Is Closing. Source: DHCS CalAIM. Retrieved September 28, 2026, from https://www.fqhctalent.com/intel/strategy-ecm-volume-urgency
More in Strategy & Tactics
Sep 1
Texas's Medicaid application backlog grew from about 1,600 in January to more than 210,000 in August, and on-time processing fell from over 90% to 62%
Aug 24
TMHP IAMOnline Release 4 Takes Effect August 24, Verify Activation Through TMHP Before Using an Email Link
Aug 24
TMHP Release 4 Is Effective August 24 for LTC, EVV and Care Forms, Confirm Access and Assigned Roles
Aug 17
Health Net is ending its Medi-Cal assisted living benefit for about 3,500 members at year-end, and two partner plans intend to follow