The impending implementation of the Affordable Care Act means an increasing focus on integrated healthcare. The behavioral health community has taken some steps towards integration in recognition of this fact, but a major driver of integration in many states is Medicaid reform which is occurring as a result of healthcare reform. States are increasingly encouraging and mandating healthcare integration by enrolling individuals who are eligible for Medicaid into managed care and coordinated care programs whose responsibilities cover all healthcare needs of these individuals. Behavioral health providers who are not part of the networks of care being created will not survive. The loss of these providers would have a direct impact on adults with serious mental illnesses and children with serious emotional disturbances. Specialty behavioral health providers are better prepared to provide services based on evidence and best practices given their experience, skills and competencies in working with these populations. Thus, it is imperative that they be a provider in the network of care. Further, as health care integration strategies move forward, individuals with mental illnesses may be faced with a bewildering choice of health insurance plans that are available through health insurance exchanges as the state and other entities initiate their strategies to enroll them in networks of care. Although States are required to fund navigators to perform outreach and provide information regarding health insurance programs and associated benefits to individuals who will be enrolled in these networks, it is critical that the navigators are well versed with regard to the behavioral health needs of individuals with mental illnesses so that they can provide information that will assist individuals in choosing the best insurance to meet their needs. This informative session will provide examples of several states that are addressing these issues using exemplary and cutting edge strategies in preparation for the implementation of the Affordable Care Act.
CEO of Smoky Mountain Center
Senior Policy Advisor for the Texas Department of State Health Services