title: Expected Impact of Health Care Reform on the Organization and Service Delivery of Publicly Funded Addiction Health Services.
abstract: Little is known about how the Affordable Care Act (ACA) will be implemented in publicly funded addiction health services (AHS) organizations. Guided by a conceptual model of implementation of new practices in health care systems, this study relied on qualitative data collected in 2013 from 30 AHS clinical supervisors in Los Angeles County, California. Interviews were transcribed, coded, and analyzed using a constructivist grounded theory approach with ATLAS.ti software. Supervisors expected several potential effects of ACA implementation, including increased use of AHS services, shifts in the duration and intensity of AHS services, and workforce professionalization. However, supervisors were not prepared for actions to align their programs' strategic change plans with policy expectations. Findings point to the need for health care policy interventions to help treatment providers effectively respond to ACA principles of improving standards of care and reducing disparities.
authors.affiliation: USC School of Social Work, University of Southern California, 1150 South Olive Street, Los Angeles, CA, 90015, USA. erickgue@usc.edu.
authors.forename: Erick G
authors.initials: EG
authors.lastname: Guerrero
authors.affiliation: Kent School of Social Work, University of Louisville, Louisville, KY, 40292, USA.
authors.forename: Lesley
authors.initials: L
authors.lastname: Harris
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Box 71579, 760 Westwood Plaza, Los Angeles, CA, 90024, USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Padwa
authors.affiliation: USC School of Social Work, University of Southern California, 1150 South Olive Street, Los Angeles, CA, 90015, USA.
authors.forename: William A
authors.initials: WA
authors.lastname: Vega
authors.affiliation: USC School of Social Work, University of Southern California, 1150 South Olive Street, Los Angeles, CA, 90015, USA.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Palinkas
mesh_terms: D005380:Financing, Government / Q000331:legislation & jurisprudence / Q000458:organization & administration; D006801:Humans; D007407:Interviews as Topic; D015141:Los Angeles; D009936:Organizational Innovation; D058991:Patient Protection and Affordable Care Act; D016320:Substance Abuse Treatment Centers / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D014481:United States
keywords: Addiction health services; Health care reform; Organizational change