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The Promise of Accountable Care Organizations: “The Code,” Reimbursement, and an Ethical No-Win Situation for Behavior Analysts

  • Abraham Graber
  • Matthew O’Brien
Discussion and Review Paper
  • 84 Downloads

Abstract

Clinical ethics, with its emphasis on the actions of clinicians, risks overlooking the ways in which broader health-care structures influence the behavior of health-care providers. Analysis of a factual case study demonstrates that status quo reimbursement practices may place behavior analysts in a position where, no matter how they act, they risk acting unethically. By contrast, the reimbursement model set by accountable care organizations (ACOs), part of the Patient Protection and Affordable Care Act (also known as Obamacare), may offer a solution. However, making good on the promise of ACOs will require more resources than any individual behavior analyst possesses. In order to encourage institutional structures that facilitate ethical practice, behavior analysts’ professional organizations should engage in contemporary political discussions about the state of American health care.

Keywords

Ethics Reimbursement Accountable care organizations The professional and ethical compliance code for behavior analysts Affordable care act 

Notes

Compliance with Ethical Standards

Conflict of Interest

As the spouse of an applied behavior analysis (ABA) service provider, Abraham Graber has an interest in the reimbursement rate for behavior analysts. As a clinic director and an ABA service provider, Matthew O’Brien has an interest in the reimbursement rate for behavior analysts.

Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Association for Behavior Analysis International 2018

Authors and Affiliations

  1. 1.Department of Philosophy and ClassicsUniversity of Texas at San AntonioSan AntonioUSA
  2. 2.Center for Disabilities and DevelopmentUniversity of Iowa Children’s HospitalIowa CityUSA

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