Academic journal article Journal of Psychology and Christianity

A Brief Review of the Implications of the Affordable Care Act for the Practice of Psychology

Academic journal article Journal of Psychology and Christianity

A Brief Review of the Implications of the Affordable Care Act for the Practice of Psychology

Article excerpt

The healthcare workforce of the future must be prepared for an evolving patient care system that utilizes an increasingly evidence-based, teambased, integrated care environment based on defined, interprofessional competencies-from prevention to primary to tertiary care-for patients and families across the lifespan (Institute of Medicine, 2001; Rozensky, 2012; Wilson, Rozensky, & Weiss, 2010).

Changes to the healthcare delivery system, detailed in the Patient Protection and Affordable Care Act (ACA; Public Law No: 111-148, Mar 23, 2010:) and supported as constitutional by the U.S. Supreme Court (National Federation of Independent Business v. Sebelius, 2012), focus on interprofessional organizations (such as accountable care organizations and patient-centered healthcare homes) as the nexus of the delivery of efficient, cost effective, and quality healthcare services (Orszag & Emanuel, 2010; Rozensky, 2011). Nordal (2012) noted that consumers and providers alike experience "angst" in response to these changes but that this can be moderated by "taking an active role in defining our future" (p. 542); such actions can be taken by the field and by each individual practitioner. While this article is focused primarily on the practice of professional psychology, the issues presented and recommendations provided apply equally to any behavioral and mental health professional whose practice will be impacted by the upcoming changes to the healthcare system.

Actions Professional Psychologists Should Take to Successfully Participate in the Upcoming Changes to the Healthcare System

Given the upcoming demands of the ACA and the evolving healthcare system, this article will focus on four broad areas of opportunity in which to take action: (a) interprofessionalism, (b) workforce and practice settings, (c) professional accountability (evidenced-based care, specialization, self-definition, identity, and autonomy), and (d) reimbursement (cost offset and advocacy). These are based upon 15 action steps required to build the future of professional psychology (Rozensky, 2011). Each of these topics responds to the demands for both affordable care and enhanced accountability in the developing healthcare system.


The impact of interprofessional care on quality and cost savings is recognized in the ACA in Section 3502, Establishing Community Health Teams to Support The Patient-Centered Medical Home. That section of the law states that funding can be made available to establish community-based, interprofessional (primary) healthcare teams that may include behavioral and mental health providers (including psychologists). The law also describes interprofessional, integrated disease prevention and health promotion services (including funding for clinical teaching settings such as academic health science centers and communitybased teaching health centers) and interprofessional models of healthcare (including integration of physical and behavioral/mental health services).

Wilson, Rozensky, and Weiss (2010) reviewed how Federal policy recommendations support "the integration of interprofessional education (IPE) into health professions education as a means of assuring a more collaborative health care workforce" of the future (p 210). This reflects "an enlightened new professionalism that can lead to better services and consequent improvements in the health of patients and populations" (Frenk et al, 2010; p 1954). As a response to what has been seen as fragmented healthcare practices, interprofessionality is defined as "the development of a cohesive practice between professionals from different disciplines" (D'Amour & Oandasan, 2005; p 9) including shared competencies formed during education and training (Schuetz, Mann, & Evertt, 2010) and utilized in practice in an integrated, team-based healthcare system (Interprofessional Education Collaborative, 2011). These competencies are shared across all disciplines and include values and ethics, roles and responsibilities for collaborative practice, interprofessional communication, and team work and team-based care. …

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