March 6, 2013: PCS, ACA and You

by Dr. David Reynolds, Pastoral Counseling Services Center Director

What is Affordable Care Act (ACA)?

In healthcare, much discussion, speculation, and confusion is happening around healthcare reform. The Affordable Care Act (ACA) is making great changes in healthcare generally and in behavioral health specifically. The four major areas addressed by the ACA are insurance reform, coverage expansion, delivery system reform, and payment reform. New protections that are in effect have been welcomed by most consumers and providers: insurance companies cannot deny coverage; preexisting exclusions are banned; annual and lifetime limits on coverage are prohibited; and coverage has been extended for children up to age 26.

No one knows what the final product will look like as the Executive Branch, Congress, states, and the citizenry work on this major overhaul. The overall goals of the ACA are to improve quality and manage costs by focusing on and early intervention, improving the management of chronic health conditions and finally reducing errors and waste in the healthcare system. Few would argue with these laudable goals.

What Does This Mean To You?

What does this have to do with PCS, clients, providers, and our colleagues? I will comment on two areas. First, early intervention and preventative care are central to behavioral health. The relationship of medical issues such as heart disease, diabetes, stroke, ulcers, and other disorders often co-exist with mental health disorders such as depression, anxiety, and substance abuse. Often, the mental health disorders are not treated or undertreated. PCS clinical staff has seen what many studies have demonstrated that effective psychotherapy can have a positive effect on medical issues.

Second, you will hear much discussion about “healthcare homes” in the ongoing discussion. Since mental and medical health often interrelate, communication between multiple providers is essential. Healthcare homes will be a more intentional relationship between various providers. PCS clinical staff already consults with other healthcare providers when indicated and authorized by our clients. It appears more organic and official connections between mental and medical providers will be happening with the ACA.

The highest value is providing the highest quality of care to our clients. Escalating healthcare costs, the number of uninsured and underinsured, and the high incidence of “preventable deaths (e.g. heart disease, diabetes, etc.)” have initiated the major reforms that are coming down the pike. PCS will monitor the complex process of reform. We will also be working to position ourselves to be able to continue to provide the highest quality of mental healthcare available to our clients.