Jerry McKee, PharmD, MS, BCPP and Sheila Botts, PharmD, FCCP, BCPP
The Affordable Care Act (ACA) made mental and behavioral health treatment one of 10 essential benefits required in new insurance policies sold on the federal health exchange and Medicaid. The expansion of coverage was expected to yield comprehensive coverage of mental illness, equal to that of medical and surgical needs. Yet, currently, coverage for mental health disorders includes state-by-state disparities; and within states, attempts to include it range from almost nonexistent to a variety of creative experiments in health delivery models and payment structures. Many of those seeking treatment are finding shortages of mental health providers and treatment facilities as well as gaps in insurance coverage.
With the advent of "whole patient" accountable care, a new set of economic incentives are transforming the larger healthcare system, and behavioral health providers are finding themselves in an opportune position to positively influence total cost of care and quality metrics. Subsequently, new collaborations and economic incentives are emerging, often with the desire to provide comprehensive medication management and coordination services. There is much excitement regarding what the ACA may do to support patients with severe and persistent mental illnesses and the providers who care for them.
To assist in sharing what is currently known, as well as identifying key questions for the future, the CPNP Programming Committee has put together a session designed to discuss the impact of the ACA on mental health care and gaps in service delivery. Program objectives include a review of the impact of ACA and Medicaid expansion on health care coverage, access, and affordability, identification of delivery models that may improve access and clinical outcomes, and a discussion of the role of health care homes including effectiveness, necessary resources and personnel, and the role of pharmacy.
CPNP is delighted to have commitments from Joseph Parks, M.D. and Troy Trygstad, Pharm.D., PhD. to lead this discussion on the impact of the ACA on mental health care and gaps in service delivery from the perspective of two different healthcare eco-systems (note CCNC is a private 501c3) and their innovative approaches to mental health care delivery. Dr. Parks is the Chief Medical Officer for the Missouri Department of Mental Health and serves as President of the Medical Director’s Council of the National Association of State Mental Health Program Directors. In October of 2011, Missouri became the first state in the nation to receive the approval of a Medicaid State Plan Amendment allowing for the establishment of Healthcare Homes (HCHs) under the Affordable Care Act. Dr. Trygstad is the Vice President of Pharmacy Programs for Community Care of North Carolina (CCNC) and through his work in both public policy and private practice partnerships has furthered incorporation of pharmacy into integrated care at the state and national level.