Health Reform: What You Need To Know
What the Affordable Care Act Offers
By Rebecca A. Clay
Integration of behavioral health and primary care is another major theme within the Affordable Care Act.
For example, the law allows states to add a “health home” option to their Medicaid coverage (see What Are Health Homes?). Health homes “fit all the pieces together” for
individuals with chronic conditions, explained Charles Ingoglia, M.S.W., Vice President for Public Policy at the National Council for Community Behavioral Healthcare. In these long-term relationships, consumers select providers who will be responsible for coordinating all of their care, sharing information electronically with other providers, and handling tasks like followup that often fall through the cracks.
That concept is especially helpful for people with behavioral health issues, said Mr. O’Brien. “Studies have shown that 70 percent of individuals with significant mental health or substance use disorders have one or more chronic conditions,” he pointed out.
Behavioral health providers should already be preparing for the integration of behavioral health and primary care, emphasized Rita Vandivort-Warren,
M.S.W., a public health analyst in the Division of Services Improvement at SAMHSA’s Center for Substance Abuse Treatment.
“It’s important for mental health and substance abuse providers to develop good linkages with primary care practitioners,” she said, adding that there are various models of integration. “Sometimes it’s the behavioral health provider doing screening and brief interventions in the primary care site; sometimes it’s the primary care provider giving services in behavioral health organizations.”
Providers should also ensure that they’re ready to embrace electronic medical records and understand Medicaid billing procedures, added Mr. Randazzo.
Many details of ACA’s implementation are still to be worked out. SAMHSA will play a key role in that process.
To help influence what happens with provisions related to behavioral health, SAMHSA crafted a white paper laying out its vision for a good, modern addictions
and mental health service system. “We wanted to get ahead of the curve,” said Mr. O’Brien.
SAMHSA is already involved in helping to shape specific ACA provisions. States must consult with SAMHSA as they craft their plans for health homes, for example.
Consumers, providers, and other stakeholders should get involved, too, emphasized Mr. Randazzo. They should stay informed about what’s happening, get engaged, and share their input on such matters as what specific behavioral health services will be included in the essential benefits package, how the new insurance exchanges are constructed, and so on.
“We want to make sure behavioral health is at the table,” said Mr. Randazzo. “With other people’s involvement, we can keep behavioral health concerns at the
For more information about the Affordable Care Act, visit http://www.healthcare.gov. This site features a timeline, video chats, and even an interactive database of insurance options in addition to basic information about the law.
For more information about ACA’s impact on behavioral health, visit SAMHSA’s newly redesigned Web site and click on the Agency’s Strategic Initiative on Health Care Reform.