People in Medi-Cal with complex behavioral and physical health needs face a fragmented system that is challenging to navigate. This paper offers recommendations to build an integrated system of care in Medi-Cal, bringing together physical health, mental health, and substance use services to treat the whole person.

In 2019 plan choice on Covered California remained stable. Similar to 2018, 4% of enrollees in 2019 had only one health plan (meaning only one insurer) to choose from. Ninety six percent had at least two, and 81% had at least three. The majority of enrollees who had only a single choice continued to live primarily in Santa Barbara, Monterey, and San Luis Obispo Counties.

This report describes approaches many states are taking to use financial incentives with Medicaid managed care plans to accelerate quality improvements. There is an opportunity to build on current quality improvement efforts in Medi-Cal managed care, led by the California Department of Health Care Services, through financial incentives.