Behavioral health integration in Medi-Cal: a blueprint for California
- Collection:
- Health Policy and Services Research
- Author(s):
- Kelly, Logan, author Hamblin, Allison, author Kaplan, Stephen, author
- Contributor(s):
- California HealthCare Foundation, issuing body. Well Being Trust, issuing body.
- Publication:
- [Oakland, California] : California Health Care Foundation, February 2019
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Delivery of Health Care, Integrated -- organization & administration Medicaid Mental Disorders -- therapy Mental Health Services Substance-Related Disorders -- therapy Behavioral Medicine Financing, Government Health Workforce Managed Care Programs Medicare State Government Humans California United States
- Genre(s):
- Technical Report
- Abstract:
- A recent poll released by the California Health Care Foundation and Kaiser Family Foundation showed that approximately half of all Californians think that people with mental health or alcohol or drug problems do not receive the services that they need. Notably, these percentages are higher among respondents who have themselves sought behavioral health services. Medi-Cal enrollees with physical and behavioral health needs must navigate multiple separate systems to receive needed care--often leading to confusion that may hinder access to care, stress, and increased health care costs. This paper puts forth recommendations to build an integrated system of care in Medi-Cal--one that brings together physical health, mental health, and substance use services to treat the whole person. Currently, Medi-Cal enrollees with complex behavioral and physical health needs often fail to receive needed care because they must seek it across multiple disconnected service delivery systems. The framework proposed in this paper builds on areas of strength within the current structures, while addressing the systemic barriers to improving care due to the current organization, financing, and administration of physical health care, mental health care, and substance use disorder (SUD) care in Medi-Cal. The disparate funding streams and decentralized structures of behavioral health care in Medi-Cal have evolved over decades through a series of legal, political, and financial arrangements. As a result, most enrollees who need care for chronic physical, mental health, and SUD issues confront three separate systems. Navigation across these systems is typically left to the consumer to figure out. Looking from the systems level, the disconnected responsibilities for health services in Medi-Cal limit each entity's incentives to invest in whole-person care, preventive care, and early intervention across the continuum of needs. Fragmentation in the current system often results in critical disruptions in care and a lack of care coordination, which lead to poor health and social outcomes, as well as increased health care costs. It is an axiom in health care that every system is perfectly designed to get the results it achieves. In Medi-Cal, if California aims to meaningfully improve outcomes for people with behavioral health needs, the systems that serve them must be redesigned accordingly.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)
- Extent:
- 1 online resource (1 PDF file (25 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101758721 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101758721