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A history of government-funded health and behavioral health services has resulted in separate and parallel systems of care for Medicaid beneficiaries. Accountability for coordination of medical and behavioral services has been poorly delineated, with adverse consequences for the medically indigent population. The author defines current opportunities and approaches for service coordination within the Medicaid arena.

With the growing emphasis on developing public/private-sector collaborations for the provision of behavioral healthcare services to Medicaid recipients, one of the key issues will be clarifying the distinction between provider networks and systems of care. The latter provide a comprehensive spectrum of vertically and horizontally integrated services to targeted populations. Public/private collaborations will also require new and modified outcomes measurement systems and quality management programs, building on what already exists in each sector.