Weaving Together Mental and Physical Health Care Outside the Safety Net
A growing body of evidence shows that integrating mental health into primary care services can increase mental health care access and coordination, improve patient outcomes, and reduce health care costs, particularly for those with co-occurring chronic conditions. Traditional safety-net providers have made strides toward offering mental health services in tandem with physical health services. In part this integration has been supported by payment systems. Yet most people covered by Medi-Cal, California’s Medicaid program, receive care outside the safety net, where integration has not yet taken hold.
This paper focuses on opportunities to support practice change in primary care to deliver integrated care outside the safety net. It is the result of research and interviews conducted between February and May of 2019 with 15 people at different types of entities, focused on both challenges and strategies for integration outside the safety net. Interviewees included payers (commercial, Medicare, and Medi-Cal plans), managed behavioral health organizations, and physical and behavioral health providers (independent practice associations, medical groups, and integrated delivery systems).