Mental health experts call for psychologists and other medical providers to be in the forefront of health care reform as new reimbursement initiatives seek to blend medical and behavioral health payments.

American health care has long been criticized as providing primarily medical care with mental and behavioral services viewed as separate and less essential entities. Moreover, only 5 percent of the “health” care expenditures in America go toward prevention.

Escalating costs have make health reform a priority. As such, legislation being contemplated as well as laws that have already passed will ensure that future health care will represent a different product from what currently exists.

“We looked at psychology departments here in the United States and in other countries to determine what worked best when implementing the policies outlined in health care reform,” said Nancy Cheak-Zamora, Ph.D.

“Many providers, especially psychologists, work independently, but the new health care law is encouraging providers to develop a medical team approach, one that can tackle many different aspects of a disease.”

The new law encourages providers to bundle payment methods, study best practices, and develop accountable care organizations (ACO), which are formal groups or institutions that include teams of general practitioners and specialists taking a team approach to patient care.

ACOs will have a financial stake in the outcomes of their patients. These changes could force a major shift in health care providers’ practices, including those in psychology and rehabilitation.

Physicians and psychologists, and specifically rehabilitation psychologists, need to move away from the traditional model of considering mental and behavioral health care services as separate from medical care, Cheak-Zamora said.

Cheak-Zamora said that large professional organizations, such as the American Psychological Association, should take the lead to help form expectations and policies for the team approach.

Simultaneously, new psychologists should be trained to work in a team with other medical providers.

Benefits of a medical team include reduced unnecessary procedures, less paperwork, better coordination with other providers and specialists, and better monitoring of prescriptions to discourage abuse or unintended drug interaction.

Experts believe patients and providers need to be educated about the current system, how to access care, how to get questions addressed, and how to get the quality care patients deserve.

“With the implementation of healthcare reform, many patients might have been uninsured or underinsured for so long that they no longer know how the system is supposed to benefit them,” Cheak-Zamora said.

“They need to know how to access insurance information and utilize the system effectively.”

Additionally, medical staff will need to be trained to handle requests through the new system, and how to work with individuals that do not have experience with insurance.

“Health care reform is an outline of what the government wants. Policymakers are working to develop policies, so now is the time to air any concerns and help shape a policy that works for everyone,” she said.

Source: University of Missouri