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Behavioral Health and Health Care Reform Models: Patient-Centered Medical Home, Health Home, and Accountable Care Organization

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Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient-Centered Medical Home, the Health Home initiative within Medicaid, and the Accountable Care Organization. To incorporate behavioral health into health reform, policymakers and practitioners may consider embedding in the reform efforts explicit tools—accountability measures and payment designs—to improve access to and quality of care for patients with behavioral health needs.

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Dr. Bao received funding from the National Institute of Mental Health (K01MH090087 and P30MH085943). Dr. Pincus received funding from the Irving Institute for Clinical and Translational Research at Columbia University (UL1 RR024156) from the National Center for Research Resources, a component of the National Institutes of Health; Mental Health Therapeutics Center for Education and Research in Therapeutics (CERT) at Rutgers. Additional funding for Dr. Pincus came from government and nongovernment organizations of the countries participating in the International Initiative for Mental Health Leadership project (Australia, Canada, England, Germany, Ireland, Japan, the Netherlands, New Zealand, Norway, Scotland, Taiwan, and the USA).

Conflict of Interest

Dr. Pincus has submitted a detailed statement of potential conflicts of interest, which remains on file at the Journal’s editorial office; there appears to be no conflicts of interest.

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Correspondence to Yuhua Bao PhD.

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Bao, Y., Casalino, L.P. & Pincus, H.A. Behavioral Health and Health Care Reform Models: Patient-Centered Medical Home, Health Home, and Accountable Care Organization. J Behav Health Serv Res 40, 121–132 (2013).

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