Healthcare Reform Models Health Care Reform Models Essay

Healthcare Reform Models

Health Care Reform Models

Preventive Psychiatry

Shim and colleagues (2012) argue for taking advantage of provisions within the Patient Protection and Affordable Care Act (ACA) of 2010 that emphasizes preventive and integrated care. They propose that the primary care setting is ideal for screening patients for signs of mental illness and associated risk factors. A mental health wellness program could also include coaches and other experts that interface with patients on an individual basis, including at the patient's home.

Long-Term Behavioral Health Care

Bao and colleagues (2012) examined four patient populations defined by disease severity and ability to pay, and then assessed how these four groups will fare under the behavioral health provisions in the ACA. Patients with private insurance and suffering from mild to moderate mental illness will probably receive the best care at a Patient-Centered Medical Home (PCMH). The authors suggest that the presence of comorbid conditions of sufficient severity may not received the best care in this setting because these patients often need specialized care not typically found in a primary care setting.

Health Homes are intended to serve Medicaid patients with mild to moderate mental health problems (Bao, Casalino, and Pincus, 2012). In contrast to behavioral health services provided in a primary care setting, Health Homes will represent government-funded behavioral health clinics serving sometimes large populations. Some of these organizations will have incorporated primary care services into their organization. The foreseen limitation of Health Homes is that the patient population will still be underserved by primary care services.

Accountable Care Organizations (ACOs) are provider led and offer patient populations comprehensive care services (Bao, Casalino, and Pincus, 2012). The patient populations that will likely receive the best care at ACOs are those with mild to moderate mental health problems and are covered by private insurers or Medicare. Since ACOs are managed and funded by commercial health providers, there is likely to be little financial incentive for these organizations to provide services to Medicaid patients.

OEM/PCMH/ACO Integration

The American College of Occupational and Environmental Medicine (ACOEM) recently published a policy statement…