Upward Health announced today its selection by San Francisco Health Plan (SFHP) to deliver Enhanced Care Management (ECM) services to a high-complexity cohort of SFHP’s membership. SFHP provides health insurance to over 160,000 residents of San Francisco through California’s Medicaid program, Medi-Cal. ECM is a comprehensive, community-based care management service focused on both clinical and non-clinical needs. The program is part of the CalAIM (California Advancing and Innovating Medi-Cal) multi-year plan to integrate social services and improve outcomes for Medi-Cal beneficiaries.

Upward Health recognized the partnership opportunity with SFHP as a natural fit. Upward Health has been delivering its in-home, whole-person model of care to high-risk and high-need patients across the country, including within California, for years. ECM similarly serves individuals with complex needs, categorized as unique Populations of Focus defined by the State of California’s Department of Health Care Services. The Populations of Focus include those suffering from homelessness, those managing serious mental illness or substance use disorders, those transitioning from incarceration, and several other vulnerable groups.

“We are excited about the chance to impact the patients that we care about most – patients who have fragmented care and who need help to access the support available in the community,” said Glen Moller, CEO of Upward Health. “We look forward to working with the outstanding team at SFHP to engage in this good work.” San Francisco County is the most recent addition to the counties in the state where Upward Health is providing ECM services.

Patients referred to ECM with Upward Health will work with a dedicated Care Specialist who will serve as the care manager providing support and coordination. ECM is a high-touch, person-centered program focused on coordinating physical, behavioral, and social services. Patients participating in ECM receive help with a range of services, including finding doctors, scheduling appointments, understanding and tracking medications, and finding and applying for community services such as housing supports.

“Upward Health’s commitment to underserved communities and to addressing the social determinants of health made them an easy choice,” said Yolanda Richardson, CEO of SFHP. “We look forward to this partnership and improving the health of our members with the greatest needs.”

ABOUT UPWARD HEALTH

Upward Health is an in-home multidisciplinary provider that partners with health plans and other risk-bearing entities to address the unique needs of the most high-risk, high-need users of the health care system today. Using a unique, in-home community-based approach to meeting a patient’s needs, Upward Health facilitates and delivers care that improves outcomes and the quality of life for every patient it serves. Upward Health has a measured Net Promoter Score of 86, among the highest in the healthcare industry. To learn more, please visit www.upwardhealth.com.

ABOUT SAN FRANCISCO HEALTH PLAN

About San Francisco Health Plan San Francisco Health Plan (SFHP) has a rating of 4 out of 5 in NCQA’s Medicaid Health Plan Ratings 2021. SFHP is a licensed community health plan providing affordable health coverage to over 160,000 low- and moderate-income families residing in San Francisco. SFHP is designed for and by the residents it serves—many of whom would not be able to otherwise obtain health care for themselves or their families. Through SFHP, members have access to a full spectrum of medical services including preventive care, hospitalization, prescription drugs, family planning, and substance abuse programs. SFHP’s mission is to improve health outcomes of the diverse San Francisco communities through successful partnerships. San Francisco Health Plan is also the third-party administrator for the nationally recognized Healthy San Francisco program. For more information on SFHP, visit www.sfhp.org.

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