Improving Behavioral Health Systems Through Operational Integration: Efforts in San Mateo County

California’s Medi-Cal delivery system is fragmented. At Medi-Cal, managed care plans are responsible for physical health care and some mental health services, while plans operated by county behavioral health departments are responsible for specialty mental health services and most care for substance use disorders. When people enrolled in Medi-Cal receive their health care from multiple systems, maintaining coordinated care is a challenge, which can affect their experience and outcomes.

To address some of these challenges, managed care plans (MCPs) and behavioral health plans across California are working to create stronger bonds and better care for their joint members. This article examines San Mateo County’s efforts to streamline operational functions between its managed care plan and behavioral health department in an effort to improve member care and better manage resources.


This briefing note is based on materials developed by Edward Ortiz, a founding partner of Cruz and Partners, a specialty consultancy focused on safety net healthcare. Ortiz was a planning consultant on this project and was previously network director for the San Mateo Health Plan.

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