Affordable Care Act

What is Health Care Reform?

The passage of the H.R.3590 - Patient Protection and Affordable Care Act, or more popularly known as the Healthcare Reform bill (HCR) is expected to produce a seismic shift in the delivery of alcohol and drug prevention, treatment and recovery services in the State of California. It is anticipated that HCR will result in (among other things) modifications in how services will be funded, the type of services delivered, the venues where they are delivered, the individuals who will receive the services, the work force that delivers the services, how services are measured, and how service benefits are evaluated. When the major impact of HCR occurs in 2014 and an additional 3-5 million Californians have health insurance, a substantially different service system will provide alcohol and other drug (AOD) care (prevention, treatment and recovery services).

Resources are available to learn more about how the system is expected to change and how you can prepare for reform. We have compiled a number of informative presentations, reports, and recommendations from experts in the field to provide you with a comprehensive portal to access these resources. Discover which methods work, what the challenges are, and how to best optimize your efforts.

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Primary Care/Behavioral Health Integration

In light of anticipated changes to substance abuse treatment services due to healthcare reform, such as increased access to behavioral and physical healthcare and a heightened focus on quality and accountability, there are both clinical and business reasons for substance abuse screening, brief intervention, and treatment, to be co-located or integrated with primary care and mental health services.

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Health Information Technology

Healthcare Reform will dramatically shift the nature of addiction service delivery.  In order to understand how prevention, treatment and recovery services have changed and to document who is receiving services in California, what the services are and how well the services meet the needs of patients and communities, new data systems will be required in California.  These data systems will need to provide California’s Alcohol and Drug Programs (ADP) and state and county policy makers with the data they need to monitor prevention, treatment and recovery systems.

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Funding Strategies

Healthcare reform will bring in various new funding streams that the addiction field must learn how to navigate and manage. New financial models and billing mechanisms must be adopted in order to provide acceptable, feasible, and sustainable services in an integrated system of care. Effective and efficient management of new regulations and requirements to receive sufficient funding for services will be imperative prior to when expected changes occur.

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Workforce Development

Many of the AOD workforce have spent very little time working as part of the broader healthcare system. To orient the workforce to the environment of the health and mental health system, they need an orientation to different culture and priorities of healthcare and mental healthcare personnel.

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Performance Measurement/Dashboards

As healthcare reform changes the landscape of AOD services, the definitions of performance and the benchmarks to measure performance will change. As health care reform takes shape, the process of defining accurate and appropriate performance measures will likely need to consider the future environment of the AOD treatment field where services will no longer function as silos separated from other parts not only of the AOD system but also of the overall health care system.

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