The role of integrated care partnerships in addressing health care and social needs to achieve whole person care is important as health care costs rise and quality of care outcomes are incentivized. Medicaid reform and 1115 Medicaid waiver programs are implemented statewide as innovative programs aimed at achieving cost savings and improved clinical quality of care outcomes. Understanding how cross sector partnerships can meet the needs of individuals through integrated care cross sectoral coordination between government, social services and managed care is needed. This research study examined the role of normative care values, vision, trust, shared care, and leadership. The qualitative, bicoastal, multicase study identified best practices within California and North Carolina. A total of eight subject matter experts were interviewed through purposeful sampling using open-ended questions. Four conclusions were drawn from thematic analysis. Conclusion one: state government must be proactive, transparent, communicative, and purposely involved in assembling partners together. Conclusion two: differing viewpoints on politics, leadership, and funding must be communicated during stakeholder partnership meetings. Conclusion three: the formula for trust is a commitment to open sharing, listening, communicating, and acting on feedback. Conclusion four: complexity theory and visioning can be combined to achieve a health equity lens across sectors of care. Evaluation and best practices during waiver pilot implementation should be considered during waiver implementation. Integrated care relationships are key to success. Future research recommendations include expansion to a larger sample, a quantitative study and exploring the relationship between power, politics, and legislation.

Library of Congress Subject Headings

Medical care—California; Medical care—South Carolina; Medicaid; Integrated delivery of health care

Date of Award


School Affiliation

Graduate School of Education and Psychology



Degree Type


Degree Name


Faculty Advisor

James Rocco DellaNeve