Health care reform: Do you know what your state is doing?

With the changes in health care coming soon, know what your state is doing.

By Mary Ann McCabe, PhD, and Tammy A. Barnes

Despite challenges and delays, the Patient Protection and Affordable Care Act (ACA) will drive health care reform. It will lead to changes in the practice landscape for many pediatric psychologists, opening up more opportunities for integration into primary care settings. In response to these changes, SPP has formed a Task Force on Integrated Care, co-chaired by Terry Stancin and Lynne Sturm. One of the key aims of the task force is to educate SPP members about integrated care. This article is one piece of that effort.

Most of the implementation of health care reform is happening at the state level and families will be enrolling in new health insurance exchanges through their states. It will be important for SPP members to understand how their own state is managing reforms. Some psychologists may be relying on their academic institutions to keep abreast of changes and keep them informed. However, many psychologists, particularly those in independent practice, are finding that their state psychological associations are the best resource for understanding the impact for their own practice and are an important voice for psychology in state health care reform. It is a good time to know what your state association is doing. What’s more, SPP members in health care systems can inform state associations about reimbursement issues and other professional matters. APA has been working quite closely with state associations to help them provide leadership regarding the implications of health care reform for psychology practice and reimbursement.

Since the passage of the ACA, the Practice Directorate of APA and the APA Practice Organization (APAPO) established the State Implementation of Health Care Reform initiative. An internal team of staff, the APA Practice Health Care Team, now coordinates program development and implementation efforts related to health care reform at both the state and federal levels. Together with a State Implementation Advisory Group, this team provides resources and expertise to leaders of state, provincial and territorial psychological associations (SPTAs) and APA divisions that are working toward the development and implementation of health care reform at the state level. A number of SPTAs have organized “health care reform summits” as forums for education, strategic planning and brainstorming among member psychologists regarding the progress of health care reform in their state.

In response to the marked changes in the health care system over the past two years, the annual State Leadership Conference for SPTA leaders has focused on psychology in health care reform. The 2013 conference theme recognized the critical role of implementation of the ACA on the state level and emphasized the need for strong psychology leadership to ensure that mental health services are included in system reforms. (Video of the 2013 State Leadership Conference keynote addresses is available on APA Practice Central.) The APA State Implementation of Health Care Reform initiative also began using APA Communities* (an APA-moderated, closed professional social network) to serve state leaders and state associations as a central hub for information concerning psychology and health care reform (e.g., health care access, service delivery systems) in reports, issue briefs, journal articles and other publications. The group site also serves as a discussion forum for members to participate in conversations on topics related to state implementation of health care reform with real-time alerts about new resources or discussions.

Looking toward the future for psychology in health care reform, APA has newly created the APA Center for Psychology and Health. The center will be dedicated to advancing the contributions of psychology to health care and to the overall improvement of health status (mental/behavioral and physical). Among its early priorities will be establishing an empirical basis for the inclusion of psychologists in integrated care systems. This work will be coordinated with APA President-Elect Nadine Kaslow’s future task force on the contributions of psychologists to patient-centered medical homes (PCMH).

Outside of APA, there are several other organizations monitoring state progress in reform efforts. For example, the National Council on Behavioral Health has established a Mental Healthcare Reform blog, which shares relevant news about national health care reform. The National Academy of State Health Policy, in collaboration with the Robert Woods Johnson Foundation, has an online community, State Refor[u]m, which is a public network and state-level health reform implementation tracking resource. Also, the Patient-Centered Primary Care Collaborative is a leading coalition dedicated to advancing patient-centered care and has extensive resources on health care reform and medical homes. Finally, there are key resources that can educate the public about health care reform. For example, the federal government has a website that explains the new health insurance marketplace. The Kaiser Family Foundation just released an animated video that explains the basic changes in health coverage and cost following the ACA.

The SPP Task Force on Integrated Care will be collaborating with other divisions, APA and other groups and will continue to stay abreast of the changing landscape of practice following health care reform. Meanwhile, we are hopeful that SPP members will familiarize themselves with what their own states are doing and consider providing expertise and leadership effort through their state associations.

It will be important for SPP members to understand how their own state is managing reforms.

*As of Sept. 15, 2015, APACommunities is no longer available.