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Erschienen in: Administration and Policy in Mental Health and Mental Health Services Research 4/2013

01.07.2013 | Original Report

Care Integration in the Patient Protection and Affordable Care Act: Implications for Behavioral Health

verfasst von: Bevin Croft, Susan L. Parish

Erschienen in: Administration and Policy in Mental Health and Mental Health Services Research | Ausgabe 4/2013

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Abstract

Individuals with co-occurring serious mental illness and substance use disorders experience a highly fragmented system of care, contributing to poor health outcomes and elevated levels of unmet treatment needs. Several elements in the health care reform law may address these issues by enhancing the integration of physical and behavioral health care systems. The purpose of this paper is to analyze these elements, which fall into three domains: increasing access, restructuring financing and reimbursement mechanisms, and enhancing infrastructure. We conclude with a consideration of the implementation challenges that lie ahead.
Literatur
Zurück zum Zitat Alexopoulos, G. S., Reynolds, C. F, I. I. I., Bruce, M. L., Katz, I. R., Raue, P. J., Mulsant, B. H., et al. (2009). Reducing suicidal ideation and depression in older primary care patients: 24-month outcomes of the prospect study. American Journal of Psychiatry, 166(8), 882–890.PubMedCrossRef Alexopoulos, G. S., Reynolds, C. F, I. I. I., Bruce, M. L., Katz, I. R., Raue, P. J., Mulsant, B. H., et al. (2009). Reducing suicidal ideation and depression in older primary care patients: 24-month outcomes of the prospect study. American Journal of Psychiatry, 166(8), 882–890.PubMedCrossRef
Zurück zum Zitat Blank, M., Mandell, D., Aiken, L., & Hadley, T. (2002). Co-occurrence of HIV and serious mental illness among Medicaid recipients. Psychiatric Services, 53(7), 868–873.PubMedCrossRef Blank, M., Mandell, D., Aiken, L., & Hadley, T. (2002). Co-occurrence of HIV and serious mental illness among Medicaid recipients. Psychiatric Services, 53(7), 868–873.PubMedCrossRef
Zurück zum Zitat Buck, J. A. (2011). The looming expansion and transformation of public substance abuse treatment under the Affordable Care Act. Health Affairs, 30(8), 1402–1410.PubMedCrossRef Buck, J. A. (2011). The looming expansion and transformation of public substance abuse treatment under the Affordable Care Act. Health Affairs, 30(8), 1402–1410.PubMedCrossRef
Zurück zum Zitat Cook, J. A., Razzano, L. A., Burke-Miller, J. K., Blyler, C. R., Leff, H. S., Mueser, K. T., et al. (2007). Effects of co-occurring disorders on employment outcomes in a multisite randomized study of supported employment for people with severe mental illness. Journal of Rehabilitation Research and Development, 44(6), 837–850.PubMedCrossRef Cook, J. A., Razzano, L. A., Burke-Miller, J. K., Blyler, C. R., Leff, H. S., Mueser, K. T., et al. (2007). Effects of co-occurring disorders on employment outcomes in a multisite randomized study of supported employment for people with severe mental illness. Journal of Rehabilitation Research and Development, 44(6), 837–850.PubMedCrossRef
Zurück zum Zitat Dausey, D., & Desai, R. (2003). Psychiatric comorbidity and the prevalence of HIV infection in a sample of patients in treatment for substance abuse. The Journal of Nervous and Mental Disease, 191(1), 10–17.PubMedCrossRef Dausey, D., & Desai, R. (2003). Psychiatric comorbidity and the prevalence of HIV infection in a sample of patients in treatment for substance abuse. The Journal of Nervous and Mental Disease, 191(1), 10–17.PubMedCrossRef
Zurück zum Zitat DeJong, G., Palsbo, S. E., & Beatty, P. W. (2002). The organization and financing of health services for persons with disabilities. Milbank Quarterly, 80(2), 261–301.PubMedCrossRef DeJong, G., Palsbo, S. E., & Beatty, P. W. (2002). The organization and financing of health services for persons with disabilities. Milbank Quarterly, 80(2), 261–301.PubMedCrossRef
Zurück zum Zitat Dickey, B., Normand, S.-L., Weiss, R., Drake, R., & Azeni, H. (2002). Medical morbidity, mental illness, and substance use disorders. Psychiatric Services, 53(7), 861–867.PubMedCrossRef Dickey, B., Normand, S.-L., Weiss, R., Drake, R., & Azeni, H. (2002). Medical morbidity, mental illness, and substance use disorders. Psychiatric Services, 53(7), 861–867.PubMedCrossRef
Zurück zum Zitat Donohue, J. M., Huskamp, H. A., & Zuvekas, S. H. (2009). Dual eligibles with mental disorders and Medicare part D: how are they faring? Health Affairs, 28(3), 746–759.PubMedCrossRef Donohue, J. M., Huskamp, H. A., & Zuvekas, S. H. (2009). Dual eligibles with mental disorders and Medicare part D: how are they faring? Health Affairs, 28(3), 746–759.PubMedCrossRef
Zurück zum Zitat Druss, B. G., & Mauer, B. J. (2010). Health care reform and care at the behavioral health-primary care interface. Psychiatric Services, 61(11), 1087–1092.PubMedCrossRef Druss, B. G., & Mauer, B. J. (2010). Health care reform and care at the behavioral health-primary care interface. Psychiatric Services, 61(11), 1087–1092.PubMedCrossRef
Zurück zum Zitat Druss, B. G., Rohrbaugh, R. M., Levinson, C. M., & Rosenheck, R. A. (2001). Integrated medical care for patients with serious psychiatric illness: a randomized trial. Archives of General Psychiatry, 58(9), 861–868.PubMedCrossRef Druss, B. G., Rohrbaugh, R. M., Levinson, C. M., & Rosenheck, R. A. (2001). Integrated medical care for patients with serious psychiatric illness: a randomized trial. Archives of General Psychiatry, 58(9), 861–868.PubMedCrossRef
Zurück zum Zitat Druss, B. G., von Esenwein, S. A., Compton, M. T., Rask, K. J., Zhao, L., & Parker, R. M. (2010). A randomized trial of medical care management for community mental health settings: the primary care access, referral, and evaluation (PCARE) study. American Journal of Psychiatry, 167(2), 151–159.PubMedCrossRef Druss, B. G., von Esenwein, S. A., Compton, M. T., Rask, K. J., Zhao, L., & Parker, R. M. (2010). A randomized trial of medical care management for community mental health settings: the primary care access, referral, and evaluation (PCARE) study. American Journal of Psychiatry, 167(2), 151–159.PubMedCrossRef
Zurück zum Zitat Epstein, R. M., Fiscella, K., Lesser, C. S., et al. (2010). Why the nation needs a policy push on patient-centered health care. Health Affairs, 29(8), 1489–1495.PubMedCrossRef Epstein, R. M., Fiscella, K., Lesser, C. S., et al. (2010). Why the nation needs a policy push on patient-centered health care. Health Affairs, 29(8), 1489–1495.PubMedCrossRef
Zurück zum Zitat Federal Coordinated Health Care Office (2010) 75 Federal Register 82405. Federal Coordinated Health Care Office (2010) 75 Federal Register 82405.
Zurück zum Zitat Fields, D., Leshen, E., & Patel, K. (2010). Analysis and commentary: driving quality gains and cost savings through adoption of medical homes. Health Affairs, 29(5), 819–826.PubMedCrossRef Fields, D., Leshen, E., & Patel, K. (2010). Analysis and commentary: driving quality gains and cost savings through adoption of medical homes. Health Affairs, 29(5), 819–826.PubMedCrossRef
Zurück zum Zitat Garfield, R. L., Lave, J. R., & Donohue, J. M. (2010). Health reform and the scope of benefits for mental health and substance use disorder services. Psychiatric Services, 61(11), 1081–1086.PubMedCrossRef Garfield, R. L., Lave, J. R., & Donohue, J. M. (2010). Health reform and the scope of benefits for mental health and substance use disorder services. Psychiatric Services, 61(11), 1081–1086.PubMedCrossRef
Zurück zum Zitat Harris, K. M., & Edlund, M. J. (2005). Use of mental health care and substance abuse treatment among adults with co-occurring disorders. Psychiatric Services, 56(8), 954–959.PubMedCrossRef Harris, K. M., & Edlund, M. J. (2005). Use of mental health care and substance abuse treatment among adults with co-occurring disorders. Psychiatric Services, 56(8), 954–959.PubMedCrossRef
Zurück zum Zitat Horvitz-Lennon, M., Kilbourne, A. M., & Pincus, H. A. (2006). From silos to bridges: meeting the general health care needs of adults with severe mental illnesses. Health Affairs, 25(3), 659–669.PubMedCrossRef Horvitz-Lennon, M., Kilbourne, A. M., & Pincus, H. A. (2006). From silos to bridges: meeting the general health care needs of adults with severe mental illnesses. Health Affairs, 25(3), 659–669.PubMedCrossRef
Zurück zum Zitat Institute of Medicine. (1993). Access to health care in america. Washington, DC: National Academies Press. Institute of Medicine. (1993). Access to health care in america. Washington, DC: National Academies Press.
Zurück zum Zitat Institute of Medicine. (2006). Improving the quality of health care for mental and substance-use conditions. Washington, DC: National Academies Press. Institute of Medicine. (2006). Improving the quality of health care for mental and substance-use conditions. Washington, DC: National Academies Press.
Zurück zum Zitat Kaiser Family Foundation. (2010). Summary of new health reform law. Menlo Park: Henry J. Kaiser Family Foundation. Kaiser Family Foundation. (2010). Summary of new health reform law. Menlo Park: Henry J. Kaiser Family Foundation.
Zurück zum Zitat Kessler, R., Stafford, D., & Messier, R. (2009). The problem of integrating behavioral health in the medical home and the questions it leads to. Journal of Clinical Psychology in Medical Settings, 16(1), 4–12.PubMedCrossRef Kessler, R., Stafford, D., & Messier, R. (2009). The problem of integrating behavioral health in the medical home and the questions it leads to. Journal of Clinical Psychology in Medical Settings, 16(1), 4–12.PubMedCrossRef
Zurück zum Zitat Lord, O., Malone, D., & Mitchell, A. J. (2010). Receipt of preventive medical care and medical screening for patients with mental illness: a comparative analysis. General Hospital Psychiatry, 32(5), 519–543.PubMedCrossRef Lord, O., Malone, D., & Mitchell, A. J. (2010). Receipt of preventive medical care and medical screening for patients with mental illness: a comparative analysis. General Hospital Psychiatry, 32(5), 519–543.PubMedCrossRef
Zurück zum Zitat Manderscheid, R. (2010). Assuring the social safety net for the newly insured under national health reform. Washington, DC: National Association of County Behavioral Health and Developmental Disability Directors. Manderscheid, R. (2010). Assuring the social safety net for the newly insured under national health reform. Washington, DC: National Association of County Behavioral Health and Developmental Disability Directors.
Zurück zum Zitat New Freedom Commission on Mental Health. (2003). Achieving the promise: transforming mental health care in America. Final report. DHHS Pub. No. SMA-03-3832. Rockville, MD: U.S. Department of Health and Human Services. New Freedom Commission on Mental Health. (2003). Achieving the promise: transforming mental health care in America. Final report. DHHS Pub. No. SMA-03-3832. Rockville, MD: U.S. Department of Health and Human Services.
Zurück zum Zitat Nutting, P., Miller, W., Crabtree, B., Jaen, C., Stewart, E., & Stange, K. (2009). Initial lessons from the first national demonstration project on practice transformation to a patient-centered medical home. Annals of Family Medicine, 7(3), 254–260.PubMedCrossRef Nutting, P., Miller, W., Crabtree, B., Jaen, C., Stewart, E., & Stange, K. (2009). Initial lessons from the first national demonstration project on practice transformation to a patient-centered medical home. Annals of Family Medicine, 7(3), 254–260.PubMedCrossRef
Zurück zum Zitat O’Toole, T., Pollini, R., Gray, P., Jones, T., Bigelow, G., & Ford, D. (2007). Factors identifying high-frequency and low-frequency health service utilization among substance-using adults. Journal of Substance Abuse Treatment, 33(1), 51–59.PubMedCrossRef O’Toole, T., Pollini, R., Gray, P., Jones, T., Bigelow, G., & Ford, D. (2007). Factors identifying high-frequency and low-frequency health service utilization among substance-using adults. Journal of Substance Abuse Treatment, 33(1), 51–59.PubMedCrossRef
Zurück zum Zitat Peek, C. (2009). Integrating care for persons, not only diseases. Journal of Clinical Psychology in Medical Settings, 16(1), 13–20.PubMedCrossRef Peek, C. (2009). Integrating care for persons, not only diseases. Journal of Clinical Psychology in Medical Settings, 16(1), 13–20.PubMedCrossRef
Zurück zum Zitat Pincus, H. A., Page, A. E., Druss, B., Appelbaum, P. S., Gottlieb, G., & England, M. J. (2007). Can psychiatry cross the quality chasm? Improving the quality of health care for mental and substance use conditions. American Journal of Psychiatry, 164(5), 712–719.PubMedCrossRef Pincus, H. A., Page, A. E., Druss, B., Appelbaum, P. S., Gottlieb, G., & England, M. J. (2007). Can psychiatry cross the quality chasm? Improving the quality of health care for mental and substance use conditions. American Journal of Psychiatry, 164(5), 712–719.PubMedCrossRef
Zurück zum Zitat Shortell, S., Casalino, L., & Fisher, E. (2010). How the centers for medicare and medicaid innovation should test accountable care organizations. Health Affairs, 29(7), 1293–1298.PubMedCrossRef Shortell, S., Casalino, L., & Fisher, E. (2010). How the centers for medicare and medicaid innovation should test accountable care organizations. Health Affairs, 29(7), 1293–1298.PubMedCrossRef
Zurück zum Zitat Substance Abuse and Mental Health Services Administration. (2008). Compendium of primary care and mental health integration activities across various participating federal agencies. Rockville, MD. Substance Abuse and Mental Health Services Administration. (2008). Compendium of primary care and mental health integration activities across various participating federal agencies. Rockville, MD.
Zurück zum Zitat Swarbrick, M., Murphy, A., Zechner, M., et al. (2011). Wellness coaching: A new role for peers. Psychiatric Rehabilitation Journal, 34(4), 328–331.PubMedCrossRef Swarbrick, M., Murphy, A., Zechner, M., et al. (2011). Wellness coaching: A new role for peers. Psychiatric Rehabilitation Journal, 34(4), 328–331.PubMedCrossRef
Zurück zum Zitat Unutzer, J., Katon, W., Callahan, C. M., Williams, J. W, Jr, Hunkeler, E., Harpole, L., et al. (2002). Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. JAMA: the journal of the American Medical Association, 288(22), 2836–2845.CrossRef Unutzer, J., Katon, W., Callahan, C. M., Williams, J. W, Jr, Hunkeler, E., Harpole, L., et al. (2002). Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. JAMA: the journal of the American Medical Association, 288(22), 2836–2845.CrossRef
Zurück zum Zitat U.S. Department of Health and Human Services. (1999). Mental health: a report of the surgeon general. Rockville: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health. U.S. Department of Health and Human Services. (1999). Mental health: a report of the surgeon general. Rockville: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.
Metadaten
Titel
Care Integration in the Patient Protection and Affordable Care Act: Implications for Behavioral Health
verfasst von
Bevin Croft
Susan L. Parish
Publikationsdatum
01.07.2013
Verlag
Springer US
Erschienen in
Administration and Policy in Mental Health and Mental Health Services Research / Ausgabe 4/2013
Print ISSN: 0894-587X
Elektronische ISSN: 1573-3289
DOI
https://doi.org/10.1007/s10488-012-0405-0

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