Behavioral health treatment delivery by social workers in accountable care organizations

Nearly half of Traditional Medicare beneficiaries receive their care through an Accountable Care Organization (ACO), in which provider groups are subject to healthcare cost and quality benchmarks for a defined patient population. Although the skills of the social work profession align with the goals of these contracts (coordination of service needs across multiple health and social care settings), there is little information on social worker inclusion as behavioral health providers in ACOs. We developed and administered a national survey of organizations (n = 227) with Medicare and Medicaid ACO contracts to provide an estimate of the percentage of ACOs that reported social worker-delivered behavioral health treatment. Approximately half of the respondents reported that social workers delivered mental health treatment, while a third reported that social workers delivered substance use treatment. Organizations that included specialty mental health treatment facilities were more likely to report social worker-delivered mental health and substance use treatment. Organizations that included rural healthcare facilities were less likely to report social worker-delivered substance use treatment. By describing the prevalence and predictors of social worker-delivered behavioral health treatment in ACOs, this study contributes foundational estimates for future research on the role of this important workforce in ACOs.