UNDERSTANDING HEALTH REFORM: Impact of Affordable Care Act on mental health coverage

By Stacie Smith • Last Updated 9:09 am on Monday, October 14, 2013

The Affordable Care Act has already made an impact on mental healthcare since the national healthcare reform’s inception. Unlike traditional insurance options, mental health benefits have been included in both Marketplace options and Medicare and Medicaid.

Marcus Cheatham

Marcus Cheatham, director of the Mid-Michigan Health District, is partnering with the Montcalm Center for Behavioral Health and chief executive officers of area hospitals to draft a business plan and secure grant monies available through the Affordable Healthcare Act. It is the hope of this group of health care providers to reduce costs for hospital emergency rooms by providing services that extend beyond those offered. Costs are incurred when a patient returns to the emergency room with a preventive condition or those who have issues with substance abuse, homelessness or an inability to properly perform personal hygiene.

Tammy Quillan

Both Cheatham and Tammy Quillan, director of the Montcalm Center for Behavioral Health, said that there has not been the need for a shift in how their agencies provide their services as there will be an expansion in Medicaid coverage in April 2014. Both services are both utilizing funding based on the State of Michigan Innovation Model. Additional information about the State Innovation Model is available at public.mphi.org/sites/sim/Pages/default.aspx.

“One thing that is interesting is that a lot of these things, the grants to states to pay for performance, most of the verbiage in the law has to do with this,” Cheatham said. “A lot of this system reform is much more important to hospitals and doctors.”

In the past, doctors and hospitals were paid for services rendered and now, under the Affordable Healthcare Act, reimbursement will be based on the quality of services provided. That further solidifies the importance of a business plan Cheatham, Quillan and others working to secure grant monies for their community outreach services they hope to implement. Hospital CEOs are enthusiastic about the possibility of reducing emergency room costs, providing high quality services and therefore securing reimbursement.

“There was not pressure on the healthcare system to be accountable for their outcomes and public healthcare too,” Cheatham said. “It is a really good change, but it is hard.”

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