Clinician's Digest


Psychotherapy and the Affordable Care Act * Ecstasy in the Consulting Room


Throughout the fall, news about the landmark Affordable Care Act (ACA), designed to extend healthcare coverage to millions of the country’s currently uninsured, has been overshadowed by the egregious technical glitches that plagued its website after its launch. But now that the worst computer issues have been addressed, more attention has begun to turn to ACA’s impact on the delivery of healthcare, including the mental health services that payers must cover under the act. ACA’s expansion of the benefits of the Mental Health Parity and Addictions Equity Act of 2008 means that millions more people will receive mental health benefits, with the mandate that they must be reimbursed at the same level as coverage for physical illnesses. At first glance, that huge growth in the potential insured client pool would appear to be a boon for therapists in private practice, but ACA’s practical impact may not be as favorable as many clinicians expect.

In the interest of efficiency, increased oversight, and cost control, ACA will effect fundamental changes in the ways that healthcare is monitored and delivered. According to Katherine Nordal, American Psychological Association’s (APA) executive director for professional practice, ACA will move insurance companies away from fee-for-service models (paying one provider for one session) toward a global payment model, in which mental health services are “bundled” with fees for other healthcare services relevant to the patient’s…

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