Summary
Researchers identify collaboration strategies used to integrate health, behavioral health, and social services for Medicaid members in California's Medi-Cal Whole Person Care Pilot program (WPC). Data were collected as part of the statewide evaluation of WPC. Authors analyzed qualitative data to examine strategies used by pilots to integrate care, network data to identify pilots that improved cross-sector collaboration (i.e., strengthened density or multiplexity of cross-sector ties) following WPC implementation, and comparative case analysis to identify strategies that differentiated pilots that improved collaboration from those that did not.
Findings: Pilots used multiple strategies to facilitate the integration of care. Network analyses identified 10 pilots that significantly improved either density or multiplexity of cross-sector ties, and one pilot with high cross-sector collaboration prior to WPC. Compared to pilots that did not improve cross-sector collaboration, these pilots meaningfully engaged partners in program design and implementation, used braided funds, and leveraged WPC to support broader systems change. These pilots also reported fewer challenges in developing and managing contractual relationships and ensuring meaningful use of data-sharing infrastructure by frontline staff responsible for care coordination.
Data sharing is necessary but not sufficient for systems alignment. Collaboration strategies focused on addressing financial barriers to integration and strengthening normative and interpersonal integration are also needed.
