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Health care reform through new delivery and financing models is creating better patient outcomes. Although the Affordable Care Act (ACA) provides impetus to these initiatives, healthcare reform is not simply about what is codified in the ACA. There are market forces – as well as other state and federal initiatives – that predate the ACA, and will greatly enhance the delivery of both medical and behavioral health care services in the future. The integration of mental health and primary care medical services with an emphasis on prevention is part of those marketplace and regulatory imperatives.