The Affordable Care Act (ACA) will bring changes as more Americans gain health insurance and seek both medical and psychiatric services. Psychiatry will be integrated with primary care and other medical specialties to provide collaborative, patient-centered care. Solo practices will be challenging to maintain inside the insurance system. Payment will be based on performance rather than fee-for-service, and new technology may give psychiatrists the ability to serve more areas remotely and reduce in-office visits. Research will focus on new care delivery systems and cost effectiveness. The ACA will affect many areas of medicine, and psychiatrists must understand the implications for their practices and their patients to continue meeting the mental health needs in their communities.
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