Safety-net providers in states that have accepted the federal funding available for Medicaid expansion under the Affordable Care Act (ACA) are experiencing a positive ripple effect, where increased insurance coverage rates among patients and thus greater financial security for safety-net institutions are translating into better care. We found that safety-net providers in states that expand Medicaid are delivering more services and better-coordinated care than what is available in states rejecting the expansion.
Of particular interest is the effect of Medicaid expansion on attempts to integrate behavioral health services with primary health care — long a thorny issue for safety-net providers. Research has shown that the Affordable Care Act (ACA) has increased access to behavioral health services. We present case studies from two provider systems that illustrate some of the innovative approaches that are improving the quality of behavioral health care at safety-net institutions.