Expanding addiction care: Health plan partners with seven California counties

Many Californians with substance use disorders also have co-occurring mental health or physical health issues. For Californians insured by Medi-Cal, receiving comprehensive care can be extremely difficult as they must navigate different systems of care. Counties fund and administer specialized substance use disorder (SUD) and mental health treatment services — through separate programs — while Medi-Cal managed care plans fund and administer non-specialized physical health and mental health.

To address these challenges, seven primarily rural Northern California counties (Humboldt, Lassen, Mendocino, Modoc, Shasta, Siskiyou, and Solano) have partnered with Partnership HealthPlan of California, the Medi-Cal managed care plan serving enrollees in these counties. They created the Wellness and Recovery Program, a pilot program to better integrate the SOUTH with non-specialized physical and mental health services.

The program is part of the state’s Drug Medi-Cal Organized Delivery System (DMC-ODS). It regionalizes substance use disorder treatment services in these seven counties, with financial resources provided by the counties, program administration provided by Partnership HealthPlan, and services provided by the county and other providers. under contract with the plan. With Partnership HealthPlan as a single entity administering all physical and SUD services provided to a Medi-Cal enrollee, the program has the potential to more easily identify and close gaps in care and ensure services are coordinated. between providers. This is the only instance in the state in which a Medi-Cal managed care plan and one or more counties are DMC-ODS partners.

Although it is too early to say for sure whether the pilot project, launched in 2020, has been effective in improving access to care and integrating services, early evidence suggests the program is achieving these goals. A logical question, then, for policy makers and program administrators is whether and to what extent this pilot project can serve as a model for future integration efforts, including the integration of specialized mental health services with physical health and SOUTH services.

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