Marcus: From Crisis Episodes to Behavioral Stability

Connecting members to the care and support they need, wherever they are.

Marcus, a 38-year-old with severe depression and substance use disorder, frequently relied on crisis services due to a lack of consistent behavioral health support.

01. Challanges

Marcus’s care was characterized by instability, disengagement, and repeated crisis cycles.

  • Key Drivers

    • Frequent behavioral health crises
    • Substance use relapse patterns
    • No consistent outpatient care engagement
    • Low adherence to treatment plans
    • Social isolation and lack of structure

02. Approach

Behavioral health services introduced structured, continuous support focused on stabilization and recovery.

  • Interventions

    • Dedicated behavioral health care coordination
    • Connection to therapy and psychiatric care
    • Medication management support
    • Enrollment in substance use programs
    • Ongoing engagement and crisis prevention planning

03. Outcome

With consistent behavioral health support, Marcus achieved greater stability and reduced reliance on crisis care.

  • Outcomes

    • Reduced crisis interventions
    • Sustained therapy engagement
    • Lower relapse frequency
    • Improved coping and emotional regulation
    • Increased independence and stability

Key shift: Marcus transitioned from crisis-driven care to consistent behavioral health management.

~70%+

Enhanced Care Management (ECM) – Care Coordination Impact

of DHCS quality measures tied to care coordination (MCAS) show improvement in access, timeliness, and continuity of care

Signal: ECM-driven coordination is directly improving member engagement and reducing fragmentation.

52%

Community Supports (CS) – Preventive & Whole-Person Care

of plans improved preventive care engagement (e.g., well-care visits) tied to upstream interventions and social supports

Signal: CS services (housing, nutrition, transitions) are contributing to better preventive care uptake and long-term outcomes.

90%

Behavioral Health (BH) – Follow-Up & Engagement

of plans meet benchmarks for follow-up after emergency department visits for substance use disorders (FUA/FUM measures)

Signal: Strong follow-up rates are improving stabilization and reducing repeat crisis utilization.

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Coordinated care improving community health and wellbeing

Advancing Healthier Communities

Our mission is to advance healthier communities by delivering coordinated care management, behavioral health services, and community-driven support systems that address the full spectrum of medical, behavioral, and social needs. Through collaboration with healthcare providers, community organizations, and trusted community health workers, we connect individuals to the resources, services, and support necessary to improve health outcomes, promote stability, and empower members to live healthier, more independent lives.

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Removing Barriers to Care

Our purpose is to remove barriers to care by aligning healthcare providers, social service organizations, and trusted community partners to deliver coordinated, person-centered support. By integrating medical care, behavioral health services, and community-based resources, we address the social and environmental factors that influence health and well-being. Through collaboration, culturally responsive engagement, and community health worker outreach, we ensure individuals can access the services, guidance, and support they need to navigate complex systems, stabilize their lives, and achieve improved health outcomes.

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