Health reform and the Affordable Care Act: The importance of mental health treatment to achieving the triple aim

摘要: Health reform efforts in the United States, including development of chronic care model [1], primary medical home [2], pay-for-performance initiatives [3], and federally-funded Medicare demonstration projects preceded passage federal 2010 Accountable Care Act (ACA). In addition to expanding health coverage uninsured populations many states, ACA provides recommendations Centers for Medicaid Services (CMS) test new payment delivery models such as Patient Centered Medical Home (PCMH) or Organizations an attempt improve quality outcomes care. Although (federally-funded insurance covering Americans ≥65 years age those with disabilities) (largely state-funded, low income certain are government-funded programs, commercial insurers following CMS lead incentivize these charges care. These ongoing gradual implementation rapidly changing system. The “true north” is achieve triple aim, improving access satisfaction care, reducing total costs [4]. Given high rate mental substance abuse disorders prevalence psychiatric comorbidity among persons illness, will be enhanced by integration behavioral services into initiatives. Indeed, given patients it difficult “bend cost curve” States without specialty hospital populations. This article describe most important changes importance integrating each efforts. We specifically highlight role integrated context micro-level innovations, Home/Health well macro-level Care.