Mental Health Care in the Accountable Care Organization

Psychiatric services (Washington, D.C.) (Impact Factor: 2.41). 06/2013; 64(9). DOI: 10.1176/
Source: PubMed


The Centers for Medicare and Medicaid Services (CMS) is promoting formation of accountable care organizations (ACOs). In these population-based models, CMS aligns a Medicare beneficiary population to an ACO with associated expenditure and quality targets, transitioning away from purely volume-based revenue of fee-for-service Medicare. Patients with mental illness are among high-cost Medicare beneficiaries, but this population has received little attention in ACO implementation. Although the ACO goals of providing chronic and preventive care in a coordinated, patient-centered manner are consistent with what some mental health providers have long advocated, the population-based orientation may be unfamiliar. In addressing the needs of high-cost, high-risk patients to meet quality and expenditure targets, an ACO should examine the quality of mental health care it provides as well as medical quality for patients with mental illness. In addition, federal agencies should invest to ensure understanding of the impact of population-based initiatives on patients with mental illness.

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    • "Also, because more severe forms of SUD often have a chronic, relapsing-remitting nature, providing some form of ongoing monitoring and recovery management has shown to be effective and cost-effective (Godley et al., 2007; White, 2008; Kelly and White, 2011; Dennis and Scott, 2012; McCollister et al., 2013). The high cost burden associated with long-term professional recovery management for alcohol and other drug addiction, however, along with increasing incentives for health care agencies to use more cost-efficient resources to help people achieve and sustain SUD remission, has promoted stronger clinical linkage to effective low-cost or freely available community mutual aid resources and has become a recent focus of the UK addiction treatment strategy (Hacker and Walker, 2013; Maust et al., 2013; Public Health England, 2013). In the addiction treatment field, promising results have been found in this regard related to the use of recovery-focused mutual-help organizations (MHOs). "
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