Economics and adaptation: Implications of the affordable care act for peer support

The Affordable Care Act has important implications for all of health and mental health care but may provide unique opportunities and challenges for peer support in both traditional settings and peer-run organizations. In particular, the expansion of Medicaid to single, childless adults – many of whom will have a behavioral health condition – will most certainly impact the demands on peer-run organizations. Because peer support is a non-medical method of support for people in recovery, peer-run organizations are not generally equipped to meet the administrative demands that are required of Medicaid providers. These services have historically been financed through state revenues and the federal mental health block grant. As the size and nature of the block grants are reduced over time, Medicaid reimbursement may become even more important to Peer-Run Organizations and Consumer-Operated Services. This presentation will give an overview of Affordable Care Act provisions that may impact peer-run organizations, with a focus on Medicaid coverage of peer support. As peer specialists are Medicaid-reimbursable in 26 states, we will differentiate between Medicaid reimbursement of peer specialists in traditional settings and those in independent peer-run organizations, and discuss potential advantages of those organizations adapting to changes associated with the Affordable Care Act.