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Behavioral Health Integration
The California Health Care Foundation is deeply committed to fostering behavioral health integration — the knitting together of mental health care and substance use disorder treatment with health care as a whole.
Sign up for CHCF updates on Behavioral Health
Publication

Washington State’s Transition to Integrated Physical and Behavioral Health Care in Medicaid

October 2020
Center for Health Care Strategies
Behavioral Health
Between 2016 and 2020, Washington State transitioned from three separate Medicaid systems for managing physical health, mental health, and substance use disorder services into one integrated system. This case study offers lessons to other states seeking to advance physical-behavioral health integration.
Publication

Cracking the Codes: State Medicaid Approaches to Reimbursing Psychiatric Collaborative Care

September 2020
Health Management Associates
Behavioral Health
This paper summarizes the approaches taken and lessons learned by the first 15 state Medicaid programs to reimburse for collaborative care, an evidence-based model of integrating behavioral health into primary care.
Publication

Weaving Together Mental and Physical Health Care Outside the Safety Net

May 2020
California Quality Collaborative
Behavioral Health, Medi-Cal
Research shows that integrating mental health into primary care services can increase access to mental health care, improve patient outcomes, and reduce health care costs. While many safety-net providers have made strides toward offering integrated services, most people covered by Medi-Cal get their care outside the safety net, where such integration has not yet taken hold. This paper focuses on opportunities to support practice change in these settings.
February 18, 2020

Briefing: Behavioral Health Integration in Medi-Cal

Behavioral Health
February 18, 2020
Join this CHCF briefing to learn about efforts to integrate physical and behavioral health care in Medicaid programs across the country and within Medi-Cal in California.
Publication

Paying for Value in Behavioral Health

February 2020
Robert Belfort, Adam Striar
Behavioral Health, Medi-Cal
State Medicaid programs are actively pursuing models of behavioral health value-based purchasing. This paper reviews well-publicized initiatives in three state Medicaid programs that have adopted different types of behavioral health value-based purchasing models.
Publication

Mental Health Tops Californians’ Health Care Priorities in Statewide Poll

February 2020
Eran Ben-Porath, Emily Hachey, Jazmyne Sutton, Jennifer Su
Behavioral Health, Health Care Costs, Coverage Trends, Medi-Cal, Workforce, Homelessness & Health Care
The survey offers detailed insight into Californians’ views on a range of critical health issues, including health care affordability and access, perceptions on homelessness, the health care workforce, Medi-Cal, and the experiences of the uninsured.
Publication

Making Behavioral Health Integration Work

February 2020
Logan Kelly, Allison Hamblin
Behavioral Health
This paper synthesizes insights from organizational leaders representing Medicaid-based partnerships in four states: Arizona, Arkansas, Colorado, and Oregon.
Publication

Voluntary Behavioral Health Integration in Medi-Cal: What Can Be Achieved Under Current Law

October 2019
Anil Shankar, Diane Ung
Behavioral Health, Medi-Cal
This paper was prepared by two attorneys with extensive experience in structuring Medicaid financing for safety-net providers. It explores different contracting structures through which a county could lead efforts to create opportunities for integration of physical and behavioral health care.
Publication

Behavioral Health Integration in Medi-Cal: A Blueprint for California

February 2019
Logan Kelly, Allison Hamblin, Stephen Kaplan
Behavioral Health
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.
Publication

Integrated Physical and Behavioral Health in Medicaid Managed Care

July 2019
Logan Kelly, Michelle Conway, Michelle Herman Soper
Behavioral Health
This brief distills insights from providers in three states — Arizona, New York, and Washington — that have recently transitioned to integrated managed care for physical and behavioral health conditions. It was written by the Center for Health Care Strategies with support from the Blue Shield of California Foundation and CHCF.
Publication

Quantifying Integrated Physical and Behavioral Health Care in Medi-Cal

July 2019
Blue Sky Consulting Group
Behavioral Health
How well does the Medi-Cal program meet the needs of patients who require both physical and behavioral health care services? Blue Sky Consulting Group has identified measures that plans and providers can use to monitor health outcomes for people who access care across multiple systems.
Publication

Mental Health and Substance Use Disorder Parity Under the ACA

July 2019
Caroline Au Yeung, Colin Planalp
Behavioral Health
The ACA mandated mental health and addiction coverage parity to beneficiaries in the individual and small-group markets and to Medicaid expansion beneficiaries. This brief, prepared by SHADAC with CHCF support, details how the ACA applied these mandates and presents estimates of the number of people affected.
September 23, 2019

Briefing — An Introduction to California’s Public Mental Health System

Behavioral Health
September 23, 2019
At this CHCF briefing participants learned the fundamentals of the history and financing of the mental health system for people insured through Medi-Cal.
Publication

Medi-Cal Moves Addiction Treatment into the Mainstream

August 2018
Molly Brassil, Carol Backstrom, Erynne Jones
Behavioral Health, Medi-Cal
A fundamental shift is underway in California to expand, improve, and reorganize Medi-Cal’s system for treating people with substance use disorders. This report summarizes the experiences of the first counties to implement this new approach.
Publication

Whole Person Care Pilot Program: A Mid-Point Check-In

March 2019
Lucy Pagel, Carol Backstrom, Hilary Haycock
Behavioral Health
Across California, 25 pilot programs are working to closely coordinate physical and behavioral health care with social services to help Medi-Cal enrollees with high-cost, complex needs. This paper provides an update on their progress and outlines remaining challenges.
Publication

Overcoming Data-Sharing Challenges in the Opioid Epidemic

July 2018
Robert Belfort, Alex Dworkowitz
Behavioral Health
Federal confidentiality rules, such as the "Part 2" rules, can be a stumbling block for primary care practices seeking to integrate substance use disorder treatment. This paper summarizes the rules and outlines steps that practices can take to coordinate care and stay within the law.
Publication

2018 Edition — Substance Use in California

October 2018
Wendy Holt
Behavioral Health
About 8% of Californians met criteria for substance use disorder, but only 10% of people with a substance use disorder received any type of treatment. CHCF's first Almanac publication to address this topic provides an overview of substance use and addiction in the state.
Publication

2018 Edition — Mental Health in California

March 2018
Wendy Holt
Behavioral Health
Mental Health in California: For Too Many, Care Not There provides an overview of mental health in California: disease prevalence, suicide rates, supply and use of treatment providers, and mental health in the correctional system. This Almanac report also includes available data on spending and quality of care.
Publication

California’s Current and Future Behavioral Health Workforce

February 2018
Janet Coffman, Timothy Bates, Igor Geyn, Joanne Spetz
Behavioral Health, Workforce
This report synthesizes data about California’s behavioral health workforce. California needs to make substantial investments to meet future demand for behavioral health professionals.
Publication

2018 Edition — Mental Health and Substance Use: A Crisis for California’s Youth

December 2018
Behavioral Health
For adolescents, mental illnesses and substance use disorders often occur together. This report paints a picture of California youth and the behavioral health conditions they face.
Publication

Infographic: Substance Use and Mental Illness Among California’s Youth

December 2018
Behavioral Health
Adolescence is when mental illness and often first presents and when drug and alcohol use typically start. Risk of developing a substance use disorder is greater for people who start using during adolescence. For adolescents, mental illness and substance use disorder often occur together. This infographic shows how these issues are intertwined and the big impact they are having on our youth.
Publication

The Circle Expands: Understanding Medi-Cal Coverage of Mild-to-Moderate Mental Health Conditions

August 2016
Don Kingdon, Molly Brassil, Erynne Jones
Medi-Cal, Behavioral Health
As of 2014, Medi-Cal enrollees with mild-to-moderate mental health conditions are entitled to receive mental health services through their managed care plans.
CHCF Blog

Guidelines for Sharing Behavioral Health Data Show Power of Collaboration

July 6, 2017
Catherine Teare
Behavioral Health, Data Exchange
Uncertainty about the legalities of behavioral health data sharing — what's permissible and what's required — slows efforts to achieve coordinated and integrated care that could benefit patients and providers. Read the full blog article.
Publication

Fine Print: Rules for Exchanging Behavioral Health Information in California

July 2015
Deven McGraw, Robert Belfort, Alex Dworkowitz
Behavioral Health, Data Exchange
The exchange of behavioral health information is constrained by operational challenges and legal concerns. Manatt Health describes the regulatory framework for sharing such data in California.
External Resource

Moving Toward Value-Based Payment for Medicaid Behavioral Health Services

Medi-Cal, Behavioral Health

This brief from the Center for Health Care Strategies describes how innovative states and Medicaid managed care organizations are building on models developed for physical health services and incorporating value-based payment arrangements into behavioral health programs.

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