Aligning for Impact: A Shared Definition and Multi-Stakeholder Insights on BHI in California
In 2024, CQC conducted a series of interviews focused on identifying sustainable financing practices to support BHI. Many interviewees observed that the lack of statewide consensus on how BHI is defined and interpreted made it challenging to incentivize and sustain the clinical work. Additionally, because California has numerous payers and complex payment arrangements that do not incentivize, and sometimes hinder, integrated care, CQC examined successful multi-stakeholder initiatives from other states to identify approaches that could inform California efforts. This paper presents findings from both efforts, offering definitions of BHI and behavioral health providers for California. It also proposes a framework and set of operational attributes tailored to the state’s diverse and complex health care landscape. These definitions and attributes are intended to advance a flexible, inclusive and contextually relevant model of BHI that reflects lessons learned about achieving multi-stakeholder alignment. Together, these efforts offer practical steps for California and other states seeking to advance integrated care.