Thursday, October 3, 2013

Change, Challenge, and Opportunity: Psychiatry Through the Looking Glass of Research

APA President Jeffrey Lieberman, M.D., is using the Psychiatric News Alert as a forum to reach APA members and other readers. Please send your comments to This column was written by Howard Goldman, M.D., Ph.D., and Dr. Lieberman.

The wheel of health care reform is in full spin as we await implementation of the 2014 health insurance changes mandated by the Patient Protection and Affordable Care Act (ACA). Although some reforms have already begun to occur, the majority of changes loom ahead as the law goes into effect in the coming years. These reforms hold important implications for psychiatrists, our allied mental health care providers, and, most importantly, our patients. This article will summarize the key elements of health care reform (HCR) and describe what APA is doing in response.

We can divide the provisions of the ACA into those focused on health care service reform and those focused on health insurance reform. Some of the latter have been in place almost from the passage of the ground-breaking law (for example, ending certain underwriting restrictions for preexisting conditions), while some begin this month or soon (enrollment in health insurance exchanges, Medicaid expansion), and still others have been postponed (for example, the employer mandate will not begin until 2015). The reforms in health care services, though under way, are more slowly affecting practice and the financing of behavioral health services.

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