The California-based hospice provider YoloCares is adding an Enhanced Care Management (ECM) program to its portfolio of services, which aims to address patients’ social determinants of health and related needs.

The nonprofit received a close to $3 million grant from the State of California to help defray startup costs for the program, which in the long term will receive reimbursement through the Golden State’s Medicaid program. 

“The program is coordinating all of the needs that the client has related to medical appointments. We’re going to look at their transportation needs. Do they need meal assistance? How is their housing situation? Psychosocial support?” YoloCares CEO Craig Dresang told Hospice News. “A lot of times these clients don’t need a nurse in the house, but maybe a spiritual care coordinator or a social worker. This program is set up to really go in and figure out what are all those social determinants that are impacting this person’s overall well being.”

YoloCares in May became credentialed as an ECM site by Partnership Health Plan of California, a Medicaid health plan. About 40% of the company’s 120 palliative care patients are Medicaid beneficiaries, according to Dresang. Through the program, patients will have a single case manager who will coordinate all of their services, some of which YoloCares will provide directly. Other services, such as transportation and meals, will be delivered through a network of community partners.

The state funding will facilitate the hiring of 17 new employees to administer the program, including clinicians, administrative staff and community health workers. It will also cover infrastructure development for the program, as well as laptops and a dedicated electronic medical record system, among other costs.

YoloCares had already been providing many of these services to its palliative care patients, mostly funded through philanthropy, according to Dresang. Now they will be able to secure regular reimbursement.

“The great thing about this grant is it’s helping us build the infrastructure, including the billing infrastructure, so that we can get reimbursed for things we’ve been doing all along, but we haven’t gotten paid for,” Dresang said. “So it’s really a life-changer for the organization and in the future.”

The program, and the grant, reflect a wider effort by California’s Medicaid program to improve care for patients with complex needs, expand palliative care and reduce costs. Currently more than half of the state’s Medicaid spending goes towards covering the care of 5% of its beneficiary population, according to YoloCares. A number of other health care organizations in California received similar grants, a total of $146.6 million to 133 agencies.

“Medi-Cal has been working to reinvent their offerings to beneficiaries,” Dresang said. “They’ve determined that this is an area they want to focus on, and they will reimburse for it.”