title: The Relevance of the Affordable Care Act for Improving Mental Health Care.
abstract: Provisions of the Affordable Care Act provide unprecedented opportunities for expanded access to behavioral health care and for redesigning the provision of services. Key to these reforms is establishing mental and substance abuse care as essential coverage, extending Medicaid eligibility and insurance parity, and protecting insurance coverage for persons with preexisting conditions and disabilities. Many provisions, including Accountable Care Organizations, health homes, and other structures, provide incentives for integrating primary care and behavioral health services and coordinating the range of services often required by persons with severe and persistent mental health conditions. Careful research and experience are required to establish the services most appropriate for primary care and effective linkage to specialty mental health services. Research providing guidance on present evidence and uncertainties is reviewed. Success in redesign will follow progress building on collaborative care and other evidence-based practices, reshaping professional incentives and practices, and reinvigorating the behavioral health workforce.
authors.affiliation: Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, New Jersey 08901; email: mechanic@rci.rutgers.edu.
authors.forename: David
authors.initials: D
authors.lastname: Mechanic
authors.affiliation: Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York, New York 10032; email: mo49@cumc.columbia.edu.
authors.forename: Mark
authors.initials: M
authors.lastname: Olfson
mesh_terms: D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration*; D058991:Patient Protection and Affordable Care Act; D011320:Primary Health Care / Q000458:organization & administration*; D014481:United States
keywords: Accountable Care Organizations; care integration; collaborative care; health homes; primary care; severe mental illness