Funder: California Health Care Foundation

Author: Logan Kelly and Allison Hamblin, Center for Health Care Strategies

February 2020 | Brief


Medicaid enrollees with behavioral health conditions — mental illnesses and/or substance use disorders — often have higher rates of chronic physical conditions, poor social outcomes such as homelessness and unemployment, and early mortality. Medicaid expenditures for this population are more than four times higher than for those without behavioral health needs, largely the result of increased physical health care spending. Informed by the growing evidence that physical and behavioral health integration can improve health outcomes and quality of life as well as reduce health care costs for this population, many states are supporting new partnerships between physical and behavioral health plans and providers to advance integrated care.

To examine how such partnerships can best promote physical and behavioral health integration, CHCS, with support from the California Health Care Foundation, interviewed leaders of organizations that are partnering to integrate care for Medicaid enrollees. Interviewees represented physical and behavioral health care in four states: Colorado and Oregon, which have regional Medicaid accountable care organizations, and Arizona and Arkansas, which have integrated specialty health plans for those with serious behavioral health needs. This resulting brief describes how these states transformed the management of behavioral and physical services. Drawing from their experiences, it identifies key elements that contribute to successful partnerships between physical and behavioral health organizations. These include:

  1. Employing joint-ownership models representing both physical and behavioral health;
  2. Ensuring stable system transitions for consumers and providers;
  3. Marrying the expertise of physical and behavioral health partners to create new and enhanced capacities; and
  4. Allowing adequate time for planning and implementation.

The lessons outlined in the report are broadly applicable for health care organizations and policymakers considering how to support successful partnerships to advance physical and behavioral health integration.

More Information

See additional resources and presentations shared at a California Health Care Foundation briefing on “Behavioral Health Integration in Medi-Cal” held on February 18, 2020.