Marrs Maddocks & Associates. Patient Protection and Affordable Care Act (PPACA). 2010; http://ppaca.com/, 2012.
Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, D.C.: National Academy Press;2001.
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Organisation for Economic Co-operation and Development. Health Care Spending in the United States and Selected OECD Countries. April 2011 2011.
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deGruy F. Mental health care in the primary care setting. In: Donaldson MS, Yordy KD, Lohr KN, Vanselow NA (Eds.) Primary care: America's health in a new era. Washington, D.C.: Institute of Medicine; 1996.
Butler M, Kane RL, McAlpin D, et al. Integration of Mental Health/Substance Abuse and Primary Care No. 173 (Prepared by the Minnesota Evidence-Based Practice Center under Contract No. 290-02-0009.) AHRQ Publication No. 09-E003. Rockville, MD: Agency for Healthcare Research and Quality; October 2008 2008.
Lurie IZ, Manheim LM, Dunlop DD. Differences in medical care expenditures for adults with depression compared to adults with major chronic conditions. The Journal of Mental Health Policy and Economics. 2009;12(2):87-95.
Stoner SC, Marken PA, Sommi RW. Psychiatric comorbidity and mental illness. Medical Update for Psychiatrists. 1998;3(3):64-70.
Collins C, Hewson DL, Munger R, Wade T. Evolving Models of Behavioral Health Integration in Primary Care 2010.
National Institute of Mental Health. The numbers count: mental disorders in America. 2008.
Kroenke K, Mangelsdorff AD. Common symptoms in ambulatory care: incidence, evaluation, therapy, and outcome. American Journal of Medicine. 1989;86:262-266.
Flottemesch T SS, O’Connor PJ, Solberg L, Asche S, Pawlson LG. 2010. Under review. Are characteristics of the medical home associated with diabetes care costs?
Robinson PJ, Reiter JT. Behavioral consultation and primary care: a guide to integrating services. New York: Springer; 2007.
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Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey replication. Archives of General Psychiatry. 2005;62(6):593-602.
Trask PC, Schwartz SM, Deaner SL, et al. Behavioral medicine: the challenge of integrating psychological and behavioral approaches into primary care. Effective Clinical Practice. 2002;5:75-83.
Evans DL, Charney DS, Lewis L, Golden RN, Gorman JM, Ranga Rama Krishnan K, Nemeroff CB, Bremner JD, Carney RM, Coyne JC, Delong MR, Frasure-Smith N, Glassman AH, Gold PW, Grant I, Gwyther L, Ironson G, Johnson RR, Kanner AM, Katon WJ, Kaufmann PG, Keefe FJ, Ketter T, Laughren TP, Leserman J, Lyketsos CG, McDonald WM, McEwen BS, Miller AH, Musselman D, O’Connor C, Petitto JM, Pollock BG, Robinson RG, Roose SP, Rowland J, Sheline Y, Sheps DS, Simon G, Spiegel D, Stunkard A, Sunderland T, Tibbits P, Valvo WJ. Mood disorders in the medically ill: scientific review and recommendations. Biological Psychiatry. 2005;58:175-189.
Daniel J, Honey, W., Landen, M., Marshall-Williams, S., Chapman, D., Lando, J. Mental health in the United States: health risk behaviors and conditions among persons with depression—New Mexico, 2003. Morbidity and Mortality Weekly Report. 2005;39:989-991.
Allison TG, Williams DE, Miller TD. Medical and economic costs of psychological distress in patients with coronary artery disease. Mayo Clinic Proceedings. 1995;70:734-742.
Compas BE, Haaga DAF, Keefe FJ, Leitenberg H, Williams DA. Sampling of empirically supported psychological treatments for health psychology: smoking, chronic pain, cancer, and bulimia nervosa. Journal of Consulting and Clinical Psychology. 1998;66:89-112.
Spiegel D, Bloom JR, Yalom I. Group support for patients with metastatic cancer: a randomized prospective outcome study. Archives of General Psychiatry. 1981;38:527-533.
Spiegel D, Bloom JR, Kramer HC, Gottheil E. Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet. 1989;2:888-890.
Fawzy FI, Fawzy NW, Hyun CS. Effects of an early structured psychiatric intervention, coping and affective state on recurrance and survival 6 years later. Archives of General Psychiatry. 1993;50:681-689.
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Hermann C, Brand-Driehorst S, Kaminsky B. Diagnostic groups and depressed mood as predictors of 22-month mortality in medical inpatients. Psychosomatic Medicine. 1999;60:570-577.
Ries DK. ACO mission: behavioral healthcare under the Medicare Shared Savings Program. June 2011 ACO Special Edition 2011. Accessed October, 23, 2011.
Fields D, Leshen E, Patel K. Driving quality gains and cost savings through adoption of medical homes. Health Affairs. 2010;29(5):819-826.
Reid RFP, Yu O, Ross T, Tufano JT. Patient-centered medical home demonstration: a prospective, quasi-experimental, before and after evaluation. The American Journal of Managed Care. 2009;15(9):71-87.
Patient Centered Primary Care Collaborative. PCMH—Evidence of Quality. 2011; http://www.pcpcc.net/content/pcmh-outcome-evidence-quality. Accessed October, 24, 2011.
Miller BF, Kessler R, Peek CJ, Kallenberg GA. A national research agenda for research in collaborative care: papers from the Collaborative Care Research Network Research Development Conference. AHRQ Publication No. 11-0067. 2011. http://www.ahrq.gov/research/collaborativecare/
Miller BF, Mendenhall TJ, Malik AD. Integrated primary care: an inclusive three-world view through process metrics and empirical discrimination. Journal of Clinical Psychology in Medical Settings. 2009;16:21-30.
“Patient Protection and Affordable Care Act”, 111 H.R. 3590 [including the Medicare Shared Savings Program under Title III—named “Improving the Quality and Efficiency of Health Care”—under the subpart for “Encouraging Development of New Patient Care Models.”].
BlueCross Blue Shield of Minnesota has launched a “shared incentive” payment model with four of Minnesota’s largest care systems—Allina Hospitals & Clinics, Essentia Health, Fairview Health Services, and HealthEast Care System. (See http://www.bcbs.com/news/plans/minnesota-largest-health-plan-signs-new-total-cost-of-care-contracts.html) In San Diego, Anthem Blue Cross is collaborating with Sharp Community Medical Group and Sharp Rees-Stealy Medical Centers on an ACO (see http://www.sharp.com/news/anthem-blue-cross-scmg-srs-collaborate.cfm).
Takach M, Purington, K., Osius, E. A tale of two systems: a look at state efforts to integrate primary care and behavioral health in safety net settings. Portland: National Academy for State Health Policy; 2010.
Bachman J, Pincus HA, Houtsinger JK, Unutzer J. Funding mechanisms for depression care management: opportunities and challenges. General Hospital Psychiatry. 2006;28(4):278-288.
National Association of Public Hospitals and Health Systems. What is a Safety Net Hospital? http://www.literacyworks.org/hls/hls_conf_materials/WhatIsASafetyNetHospital.pdf.
Collaborative PCPC. Payment Reform Task Force Agenda 2011. http://www.pcpcc.net/content/payment-reform-task-force-agenda-1182011-4pm-et.
Colton CW, Manderscheid RW. Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Preventing Chronic Disease. 2006;3(2):A42.
42 U.S.C. § 256a-1 [Under the PPACA section for “Establishing Community Health Teams to Support the Patient-Centered Medical Home” one requirement of health teams is that they “implement interdisciplinary, interprofessional care plans” § 256a-1(c)(4)] and 42 U.S.C. § 1396w-4 [Under PPACA’s “State Option to Provide Health Homes for Enrollees with Chronic Conditions”, the care team is comprised of “physicians and other professionals, such as a nurse care coordinator, nutritionist, social worker, behavioral health professional, or any professionals deemed appropriate by the State.” § 1396w-4(h)(6).]
42 U.S.C. § 1899(b)(1)(E).
Proposed rule 42 C.F.R. § 425.4.
Proposed rule 42 C.F.R. § 425.5(d)(15)(ii)(B)(4).
Proposed rule 42 C.F.R. § 425.5(d)(15)(ii)(B)(3).
29 U.S.C. § 1185a; 29 C.F.R. § 2590.712.
42 U.S.C. § 13951(c).
States with mental health parity statutes are: Alabama (§ 27-54-4(b)), Alaska (§ 21.54.151), Arizona (§ 20-2322), Arkansas (§§ 23-99-501 to 23-99-12), Connecticut (§ 38a-476a), Georgia (§ 33-29-24.1), Hawaii (§ 431 M-5), Idaho (for state employees at § 67-5761A), Illinois (215 § 5/370c), Indiana (§§ 27-13-7-14.8, 27-8-5-15.6), Kansas (§ 40-2,105a), Minnesota (62Q.47), Missouri (§ 376.811), Montana (§ 33-22-703 ), Nebraska (§ 44-793), New Hampshire (§ 415:18-a), New Mexico (§§ 59A-23E-18), New York (Ins. § 3221(1)(5)(A)), North Carolina (§ 58-3-220), North Dakota (§26.1-36-08), Ohio (§§ 3923:29, 3923:281, 3923:282), Oklahoma (§ 6060.11), Oregon (§ 743A.168), Rhode Island (Ch. 27–38.2), South Carolina (§ 38-71-290), South Dakota (§ 58-17-98), Tennessee (§ 56-7-2360 [mental health], § 56-7-2602 [substance abuse]), Texas (Ins. § 1355), Vermont (8 § 4089b), Virginia (38.2 § 3412.1:01 [mental health only]), and Wisconsin (§ 632.89).
National Advisory Mental Health Council Parity in Financing Mental Health Services (National Institute of Mental Health Archive, 1998) at 54 (listing states that had enacted mental health parity laws by 1997 as: Arizona, Arkansas, Colorado, Connecticut, Indiana, Maine, Maryland, Minnesota, Missouri, New Hampshire, North Carolina, Rhode Island, South Carolina, Texas and Vermont).
Insurance coverage for the treatment of mental illness is required by Alabama (27-54-4(a)), Arkansas (§ 23-86-113), California (Ins. § 10125), Connecticut (§ 38a-488a), Delaware (Ins. § 3578), Florida (§ 627.668), Georgia (§ 33-24-28.1), Hawaii (§ 431 M-4(c)), Illinois (215 § 5/370c), Iowa (§ 514 C.22), Kansas (§ 40-2,105), Louisiana (R.S. 22:1043), Maine (Title 24-A, §§2749, 2843, 4234-A), Massachusetts (Ch. 175, § 47B), Missouri (§§ 376.814, 376.1550), Montana (§ 33-22-703), Nevada (§§ 689A.0455, 689 C.169), New Hampshire (§ 417-E:1), New Jersey (§§ 17:48-6v, 17:48A-7u, 17:48E-35.20, 17B:26-2.1 s, 17B:27-46.1v), North Carolina (§ 58-3-220), Ohio (§ 3923:282), Oklahoma (§ 6060.11), Oregon (§ 743A.168), Rhode Island (Ch. 27-38.2), South Carolina (§ 38-71-290), South Dakota (§ 58-17-98), Tennessee (§ 56-7-2601), Texas (Ins. § 1355), Utah (§ 31A-22-625 [mandating offer of coverage]), Vermont (8 § 4089b), Virginia (38.2 § 3412.1), Washington (§ 48.21.241 [commercial insurance] and § 48.41.220 [coverage by state insurance pool]), West Virginia (§ 33-16-3a) Wisconsin (§ 632.89), and Wyoming (§§ 26-22-102, 26-22-106).
Insurance coverage for the treatment of substance abuse is required by Arkansas (§ 23-79-139), Colorado (§ 10-16-104.7), Delaware (Ins. § 3343(b)), Florida (§ 627.669), Hawaii (§ 431 M-4(b)), Kansas (§ 40-2,105), Louisiana (R.S. 22:1025), Maine (24-A, §2842), Maryland (§ 15-802), Mississippi (§ 83-9-27), Missouri (§ 376.811), Montana (§ 33-22-703), Nevada (§§ 689A.046, 689 C.166), New Jersey (§§ 17:48-6a, 17:48A-7a, 17:48E-34, 17B:26-2.1), New Mexico (§§ 59A-23-6; 59A-47-35), North Dakota (§26.1-36-08), Ohio (§ 3923:29), Oregon (§ 743A.168), Tennessee (§ 56-7-2601), Texas (Ins. § 1368), Utah (§ 31A-22-625 [mandating offer of coverage]), Vermont (8 § 4089b), Virginia (38.2 § 3412.1), and Wisconsin (§ 632.89).
Insurance coverage of autism spectrum disorders is required in California (Health & Safety Code § 1374.72), Connecticut (§ 38a-514b), Illinois (215 ILCS 5/3562.14), Indiana (§ 27-13-7-14.7), Louisiana (§ 22:1050), Nevada (§ 689A.0435), Pennsylvania (40 P.S. § 764 h), South Carolina (§ 38-71-280), Vermont (8 § 4088i), Virginia (38.2 § 3412.1:01), and Wisconsin (§ 632.895(12 m)).
42 U.S.C. § 18031(j).
42 U.S.C. § 18022(b)(1)(E).
Affordable Care Act § 1311(j); see also PHS Act § 2726 E, Internal Revenue Code § 9812. See also interim final regulations at 75 FR 5410 (February 2, 2010) and guidance published on June 30, 2010 (http://www.dol.gov/ebsa/faqs/faq-mhpaea.html), December 22, 2010 (http://www.dol.gov/ebsa/faqs/faq-aca5.html), and November 17, 2011 (http://www.dol.gov/ebsa/faqs/faq-aca7.html).
Department of Health and Human Services. Essential Health Benefits Bulletin. In: Oversight CfCIaI, ed2011:13.
National Committee for Quality Assurance. Patient-Centered Medical Home. 2011; http://www.ncqa.org/tabid/631/default.aspx. Accessed April, 14, 2011.
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Kessler RC, Demler O, Frank RG, et al. Prevalence and treatment of mental disorders, 1990 to 2003. N Engl J Med. June 16, 2005 2005;352(24):2515-2523.
Pincus HA, Tanielian TL, Marcus SC, et al. Prescribing trends in psychotropic medications: primary care, psychiatry, and other medical specialties. JAMA: The Journal of the American Medical Association. 1998;279(7):526-531.
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Fisher ES, Shortell SM. Accountable care organizations: accountable for what, to whom, and how. JAMA: The Journal of the American Medical Association. 2010;304(15):1715-1716.
Cohen JT. A Guide to Accountable Care Organizations, and Their Role in the Senate’s Health Reform Bill. Health Reform Watch: A Web Log of Seton Hall Law School’s Center for Health & Pharmaceutical Law & Policy 2010. http://www.healthreformwatch.com/2010/03/11/a-guide-to-accountable-care-organizations-and-their-role-in-the-senates-health-reform-bill/.
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Kathol RG, Butler M, McAlpine DD, Kane RL. Barriers to physical and mental condition integrated service delivery. Psychosomatic Medicine. 2010;72(6):511-518.