COMMENTARIES
Coordinating People and Knowledge:
Efficiency in the Context of the Patient
Protection and Affordable Care Act
Kimberly D. Becker, Department of Psychiatry, University
of Maryland
Bruce F. Chorpita, Department of Psychology, University
of California, Los Angeles
Eric L. Daleiden, PracticeWise, LLC
The Patient Protection and Affordable Care Act (ACA,
2010) will have a remarkable impact on mental health
services, yet enormous implementation challenges exist.
This commentary examines some of the issues related
to workforce development and performance measures
raised by Chor, Olin, and Hoagwood (2014). In particu-
lar, we examine inefficiencies related to the Mental and
Behavioral Health Education and Training Grants, cur-
rent training models, national initiatives to identify con-
sensus quality indicators, and electronic health records.
We highlight opportunities for psychology to lead effec-
tive reform by developing efficient training and knowl-
edge architectures.
Key words: Affordable Care Act, efficiency, knowledge
coordination, workforce coordination. [Clin Psychol Sci
Prac 21: 106–112, 2014]
The Patient Protection and Affordable Care Act
(Patient Protection and Affordable Care Act [ACA],
2010) will have a remarkable impact on mental health
services by expanding insurance coverage to an esti-
mated 13.4 million people with behavioral health con-
ditions (Miller, Lentz, Maududi, & Harding, 2013).
Chor, Olin, and Hoagwood (2014) provide a thought-
provoking account of the implications of the ACA on
prelicensure training and education in particular. It is
our goal to examine the complexities of some of the
issues they raise, particularly with regard to the effi-
ciency with which psychological science and practice
can adapt to the changing healthcare landscape. We
propose that efficient ways to deal with these changes
involve improving the coordination of psychology’s
core resources, people and knowledge, to enhance
clinical care.
COORDINATING THE WORKFORCE
Perhaps no issue related to the implementation of the
ACA has garnered as much attention as workforce
capacity. The collective evidence suggests that psychol-
ogy struggles even to meet the current demand (Ellis,
Konrad, Thomas, & Morrissey, 2009). Chor et al.
(2014) point out that the ACA has appropriated fund-
ing in the form of Mental and Behavioral Health Edu-
cation and Training Grants (MBHETGs) to train more
doctoral-level providers, yet these training grants may
not have the full impact that is needed in terms of
increasing workforce capacity. The ACA stipulates that
75% of $9.8 million awarded to 24 institutions in 2012
must be used for stipends to support field placements
in psychology or social work, which amounts to $7.35
million for stipends. The mean internship stipend is
Address correspondence to Kimberly D. Becker, Department
of Psychiatry, University of Maryland, 737 W. Lombard
Street, 4th Floor, Baltimore, MD 21201. E-mail: kbecker@
psych.umaryland.edu.
© 2014 American Psychological Association. Published by Wiley Periodicals, Inc., on behalf of the American Psychological Association.
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