What will Affordable Care Act mean for mental health care?

    Mental health-care providers from all over the country gathered in Philadelphia Thursday to discuss the impact of the Affordable Care Act on their work.

    The conference was organized by The Scattergood Program for Applied Ethics of Behavioral Health Care at the University of Pennsylvania, and the Scattergood Foundation.

    Participants agreed that health-care reform presents many challenges, but offers an opportunity to make mental health care more accessible, effective — and routine.

    For decades, mental health care has been relegated to the sidelines — viewed as a separate issue, offered in separate facilities, often not covered by health insurance. The Affordable Care Act calls for better integration of mental and physical health services.

    Featured speaker Zeke Emanuel, who heads the Department of Medical Ethics and Health Policy at the University of Pennsylvania, says integrating physical and mental health care is key to cost-effective health care.

    Integrating care makes ‘financial sense’

    He believes this will happen once reforms take effect.

    “Not because some piece of legislation says it,” explained Emanuel. “But because it makes financial sense for the whole system to realize that this divide between the physical and mental — it’s irrelevant.”

    Emanuel previously was an adviser on health care for the Obama administration.

    “If what we want is the best outcome for our patients, then we have to focus on the mental health side as well as physical health side,” he said.

    Emanuel cited examples of medical providers who have brought mental health care into their practice — and were able to reduce costs and improve patient outcomes.

    Conference participants said in order for this integration to spread on a large scale, payment structures have to change so providers can be paid for preventive care.

    The idea of integrated care is catching on with her company’s clients — businesses and governments, said Featured speaker Sue Schick, another featured speaker who is CEO of insurance company United Healthcare PA.

    “For years they tried to limit and reduce behavioral health care by cutting reimbursement, and I think they are beyond that now,” Schick said.

    Doing away with detached facilities

    Integrating care will require breaking down the walls between structures of care, said Matthew Hurfurd, chief medical officer for Philadelphia’s department of behavioral health.

    “We have silos that have gotten really good at treating people in a certain way, in a certain place,” he explained. “What we’re going to ask people to do now is to think, really innovatively and creatively, about changing the way they do business.”

    Conference participants said they expect to see significant changes in where and how mental health care is delivered over the next few years.

    Disclosure: The Scattergood Foundation also supports WHYY’s health and science desk.

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