Friday, March 11, 2016 - Monday, March 11, 2019, 12:00 AM

Relative to its size and wealth, the US spends a disproportionate amount on health care compared to other nations, and has poorer health outcomes compared to similar countries as well. For many patients with psychiatric illness, medical comorbidity is common and both psychiatric and medical care is often inadequate. As part of the Affordable Care Act, in 2012 Medicare implemented Accountable Care Organizations. ACOs are a new payment model in health care, and it is hoped they will encourage health care delivery innovation, and develop new care models that will improve both quality and costs of health care. In this Grand Rounds, we will review the impetus for care delivery redesign, from a general and psychiatric health policy, explain the financial incentives structure in Medicare ACOs and how that might influence care delivery, and also discuss early findings on the effects of ACOs on care for patients with psychiatric disorders.

1. Understand the prevalence of medical comorbidity among patients with psychiatric disorders.
2. Understand the changes in health care payment and financing, and how they may influence changes in mental healthcare delivery.
3. Understand early results in the effect of alternative payment models on changes in spending, use and quality of psychiatric care.

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