Many Medi-Cal members with serious behavioral health conditions — mental illness, substance use disorder, or both — have co-occurring medical conditions and must navigate uncoordinated systems for medical and behavioral health care that limit access to care. An array of existing initiatives supports care delivery that integrates physical and behavioral health needs, yet many of these efforts encounter challenges due to fragmentation at the financial and administrative levels between managed care plans and county behavioral health agencies.

The CalAIM (California Advancing and Innovating Medi-Cal) initiative will transform some aspects of care delivery and administration, with varying expected impacts on the integration of physical and behavioral health care.

This analysis of relevant CalAIM initiatives and brief case studies of recent local and national initiatives illustrate opportunities for California policymakers to help ensure that Medi-Cal members can experience the benefits of integrated care. The recommendations in this short paper can support Medi-Cal in building a more integrated system of care over the long term.