六月26 ， 2026​​ 

报告重点指出：参保人数创历史新高、服务提供商网络不断扩大，以及社区支持措施具有很强的成本效益。​​ 

SACRAMENTO —The Department of Health Care Services (DHCS) today released the latest quarterly report on Enhanced Care Management (ECM) and Community Supports. These services help Medi-Cal members stay healthier and avoid other, costlier health care services, such as emergency department visits and hospital stays. These data from July through September 2025 (Q3 2025) and a recent report highlight the continued expansion and impact of these services for Medi-Cal members.

“The continued growth of ECM and Community Supports reflects the strength of our statewide partnerships and the dedication of the care managers, providers, and community organizations who show up for Medi-Cal members every day,” said DHCS Director Michelle Baass. “These services are strengthening stability, dignity, and health for members across the state.”

KEY FINDINGS FROM THE Q3 2025 REPORT:​​ 

• 自 2022 年以来，已有近 453,000 名 Medi-Cal 会员接受了 ECM 服务，仅在 2025 年第三季度就为近 227,500 名会员提供了服务——比 2024 年第三季度增长了 59%。​​ 
• 儿童和青少年群体的增长尤为强劲，他们的参与度比 2024 年第三季度增长了 90%。​​ 
• 社区中居住且有长期护理风险的成年人中，ECM 的注册人数增加了 56%；有避免住院或急诊就医风险的青少年中，ECM 的注册人数增加了 83%。​​ 
• 管理式医疗计划显著扩大了 ECM 提供商网络，增加了更多为面临长期护理风险的成年人和需求最高的儿童和青少年提供服务的提供商。DHCS 继续鼓励各计划充分利用签约服务提供商，并确保以适当的强度提供服务。​​ 
• 自社区支持服务推出以来，已有超过52.8万名会员使用过该服务
  累计服务次数超过150万次。2025 年第三季度，近 191,000 名会员使用了社区支持服务，比去年增长了 40%。​​ 
• 全州范围内的服务覆盖范围扩大，94% 的 Medi-Cal 会员可获得至少 10 项社区支持服务，78% 的会员可获得全部 15 项社区支持服务。​​ 
• 最常用的服务仍然是医疗定制餐/医疗支持食品 (MTM/MSF) 和住房三项服务：住房导航、住房押金和租房支持。​​ 
• 辅助生活设施过渡服务的使用量出现了迄今为止最大的增长，本季度增长了 74%，因为更多成员获得了过渡到社区生活的支持。​​ 

ECM offers California’s highest level of care management, pairing members with a Lead Care Manager who coordinates physical, behavioral, and social services to support stability and improve health outcomes. Community Supports are cost-effective, optional services offered by Medi-Cal managed care plans that address health‑related needs, such as housing instability, nutrition, transitions from institutional care, and chronic condition management.

WHY THIS MATTERS: ECM and Community Supports are key pillars of California’s work to build a more coordinated, equitable, and prevention-oriented Medi-Cal system. These programs help members with complex needs connect to consistent, community‑based supports that stabilize health and reduce the need for higher levels of care. By emphasizing prevention and whole‑person care, ECM and Community Supports continue to improve health outcomes for Medi‑Cal members statewide.

Managed care plans have significantly expanded ECM provider networks, adding more providers serving adults at risk of long-term care and children and youth with the highest needs. DHCS continues to encourage plans to fully utilize contracted providers and ensure services are delivered at the appropriate level of intensity.

COST-EFFECTIVENESS AND LONG-TERM IMPACT: Findings from DHCS’ latest In Lieu of Services (ILOS) annual report show that Community Supports are helping members avoid costlier forms of care. The report studies service costs and utilization before and after members received at least one of the 12 Community Supports authorized as ILOS between January 2023 and June 2024. Ten of the 12 Community Supports studied are already demonstrating cost-effectiveness across applicable Medicaid State Plan service categories, such as emergency department visits, inpatient hospital stays, and nursing facility stays. Key findings include:​​ 

• 环境无障碍改造：净成本降低 51.4%。​​ 
• 喘息服务：净成本降低 19.9%。​​ 
• 住房押金：净成本降低 15.2%。​​ 
• 医疗定制餐/医疗辅助食品：净成本降低 10.5%。​​ 
• 社区或家庭过渡服务：净成本降低 9.1%。​​ 
• 辅助生活设施过渡：净成本降低 9.7%。​​ 

初步结果凸显了长期价值，表明投资于解决健康社会驱动因素的服务不仅可以改善成员的福祉，还可以降低 Medi-Cal 整个服务体系的成本。更多信息，请参阅此情况说明书。​​ 

ECM 和社区支持将继续存在： ECM 是加州医疗补助计划 (Medi-Cal) 为有最复杂需求的成员提供的全州管理式医疗福利。社区支持也是各州医疗补助计划的一种选择，主要依据联邦医疗补助管理式医疗法规，并以经批准的管理式医疗合同为依据。由于这些服务已融入 Medi-Cal 管理式医疗的核心结构中，而不是临时试点项目，DHCS 将继续监督实施、扩大供应商网络并支持项目的长期稳定性。​​ 

这种永久性确保成员、护理经理、提供者和社区合作伙伴能够继续投资于关系和护理模式，从而使 ECM 和社区支持有效。它还保证了数十万加州居民所依赖的重症监护协调、住房和营养支持、行为健康服务以及其他关键资源的持续性。​​ 

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通讯办公室​​ 
(916) 440-7660
DHCSPress@dhcs.ca.gov​​