Strategy: Build ECM Caseload Now Before Dec 2026 Waiver Expiration — Window Is Closing

March 4, 2026California

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 (7 populations of focus including HIV+, SMI, SUD, homelessness, 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.

Key takeaways

Screen every Medi-Cal patient for ECM eligibility — 7 populations of focus including HIV+, SMI, SUD, homelessness, 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

Primary source

DHCS CalAIM

#ecm#calaim#ryan-white#volume-building#creative-financing#chw#waiver-renewal

Cite this analysis

FQHC Talent. (2026, March 4). Strategy: Build ECM Caseload Now Before Dec 2026 Waiver Expiration — Window Is Closing. Primary source: DHCS CalAIM. Retrieved June 12, 2026, from https://www.fqhctalent.com/intel/strategy-ecm-volume-urgency

More in Strategy & Tactics

Strategy: Build ECM Caseload Now Before Dec 2026 Waiver Expiration — Window Is Closing

March 4, 2026California

(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.

Key takeaways

Screen every Medi-Cal patient for ECM eligibility — 7 populations of focus including HIV+, SMI, SUD, homelessness, 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

#ecm#calaim#ryan-white#volume-building#creative-financing#chw#waiver-renewal

Cite this analysis