Care management software built for the way ECM actually works
From the first outreach attempt to the quarterly report your managed care plan is waiting on, BTBCare keeps your Lead Care Managers, assessments, care plans, and encounters in one place, so your team can spend more time with members and less time proving the work got done.
In BTBCare for ECM
- Individualized care plans tied to comprehensive assessments, so each member's physical health, behavioral health, and social-needs picture drives a single living care plan the whole team works from.
- Interdisciplinary assessment and care-team coordination (IDT/MDT) that keeps the Lead Care Manager and every provider on the member's multidisciplinary team aligned on goals and next steps.
- Attendance, kiosk check-in, and contact logging that captures outreach attempts and in-person encounters by date and method for engagement tracking and reporting.
- Billing and claims with EDI that keep reported services and submitted encounters reconciled across multiple managed care plan contracts.
- Transportation dispatch built in, so coordinating a ride is part of the care plan, not a separate phone tree.
- Family and participant engagement tools that support member and family communication and keep contact details current.
Who champions it
ECM program director, clinical operations lead, or executive director at a CalAIM ECM provider organization (FQHC, community-based organization, behavioral health agency, or care management entity) holding contracts with one or more Medi-Cal managed care plans.
Who uses it every day
Lead Care Managers and their care teams, ECM outreach and engagement staff, care coordinators, and the operations/billing staff who track member engagement, assemble MCP deliverables, and reconcile encounters to claims.
What slows ECM teams down
Outreach standards are exacting and easy to fall short on: at least five different outreach methods over 30 days with at least one in-person attempt, and every attempt has to be documented and reportable down to the channel.
MCP reporting is fragmented across plans. Each managed care plan wants member-level data, encounter alignment, and quarterly monitoring numbers in its own format, and pulling it together by hand burns days every quarter.
Care plans live in spreadsheets, EHR free text, and email threads, so the individualized care plan, assessment, and the member's multidisciplinary team are never in one place when a coordinator needs them.
Encounters and claims drift apart. Reported services don't always line up with what gets billed, and reconciling them is manual, late, and a constant audit risk.
Transitional care moves fast. Hospital and SNF discharges need rapid follow-up, but staff often hear about a transition too late to close the loop within the required window.
Member contact information is scattered and stale, even after the expanded Member Information File added best-contact-method and referring-entity fields, so outreach attempts get wasted on bad numbers.
Caseloads, engagement status, and who-owns-which-member are hard to see across a growing team, making supervision and DHCS-style data-driven oversight reactive instead of proactive.
From a month-end scramble to a record that holds up
Outreach that actually counts: every attempt is logged by method and date so teams can prove the five-methods-in-30-days standard and move members from outreach into engagement faster.
Quarterly MCP reporting that assembles itself from the work your team already documented, instead of a frantic spreadsheet sprint at the end of each period.
One living record per member, where the assessment, individualized care plan, care team, and every coordination touch sit together for whoever picks up the case.
Encounters and claims that stay in step, so reported services match what's billed and audits stop being a fire drill.
Transitions that close on time, with discharge follow-ups and coordination tasks surfaced the moment a member changes settings.
Supervisors who can see caseloads, engagement status, and team workload at a glance, and step in before something slips.
What you get
Individualized care plans tied to comprehensive assessments, so each member's physical health, behavioral health, and social-needs picture drives a single living care plan the whole team works from.
Interdisciplinary assessment and care-team coordination (IDT/MDT) that keeps the Lead Care Manager and every provider on the member's multidisciplinary team aligned on goals and next steps.
Attendance, kiosk check-in, and contact logging that captures outreach attempts and in-person encounters by date and method for engagement tracking and reporting.
Billing and claims with EDI that keep reported services and submitted encounters reconciled across multiple managed care plan contracts.
Transportation dispatch built in, so coordinating a ride is part of the care plan, not a separate phone tree.
Family and participant engagement tools that support member and family communication and keep contact details current.
Medication management and eMAR for members whose care plans include medication review and reconciliation.
Reporting and analytics for caseloads, engagement status, and the encounter data MCPs and DHCS expect, plus role-based access and 2FA to protect member PHI.
Designed around the regulations you answer to
- Built around the CalAIM ECM Policy Guide (updated January 2026) and the seven core ECM services: outreach and engagement, comprehensive assessment and care management plan, enhanced care coordination, health promotion, comprehensive transitional care, member and family supports, and referral to community and social supports.
- Supports the outreach standard of at least five different methods over a 30-day period including at least one in-person attempt, with each attempt documented and reportable.
- Aligns documentation with managed care plan encounter and claims reporting and the Quarterly Implementation Monitoring Report expectations DHCS uses for data-driven oversight.
- Works with the expanded Member Information File and ECM Referral Standards, including best contact method and referring-entity fields.
- Designed for the ECM Populations of Focus served under Medi-Cal managed care plan contracts.
- PHI protected with role-based access, two-factor authentication, and a full audit trail.
ECM, answered
Does BTBCare follow the CalAIM ECM model and the seven core services?
Yes. The platform is organized around how ECM actually runs: outreach and engagement, comprehensive assessment and the individualized care plan, enhanced care coordination across the member's providers, health promotion, transitional care, member and family supports, and referral to community and social supports. It reflects the CalAIM ECM Policy Guide updated January 2026, and we keep pace as DHCS and the managed care plans update their requirements.
Can it help us meet ECM outreach and engagement standards?
It can. Every outreach attempt is logged by method and date, so your team can show at least five different outreach methods over a 30-day period including at least one in-person attempt, and supervisors can see at a glance which members are still in outreach versus fully engaged.
How does BTBCare help with managed care plan reporting?
Because outreach, assessments, care-plan activity, and encounters are all captured as your team works, the data you need for quarterly monitoring and member-level reporting is already there. Reporting and analytics pull it together so encounters line up with claims, instead of rebuilding everything in a spreadsheet at the end of each quarter. We support multiple MCP contracts, since most ECM providers work with more than one plan.
We hold contracts with several Medi-Cal managed care plans. Does the platform handle that?
Yes. BTBCare is built for ECM providers juggling multiple MCP contracts. Billing and claims with EDI keep reported services reconciled to what's billed across plans, and reporting can be organized by the plan and population of focus you're accountable to.
How is member PHI protected?
Access is role-based, so staff see only what their role requires, and two-factor authentication protects every login. A full audit trail records who did what and when, which supports both your internal oversight and the data-driven monitoring DHCS and the managed care plans expect.
Other care settings
Bring BTBCare to your ecm program
A 30-minute walkthrough, mapped to your care setting. No pressure — just a look at the plan, the team, and the claim on one record.