patient privacy and confidentiality, but more-protective state statutes take precedence.

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The use of electronic health records, decision support, and other information technology (IT) applications is growing.

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IT is less well developed and less commonly used for clinical care support.

Workforce

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Only physicians and certain advanced practice nurses generally are licensed to diagnose and treat.

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A more diverse workforce is licensed to diagnose and treat, including psychologists, psychiatrists, other physicians, social workers, psychiatric nurses, marriage and family therapists, addiction therapists, and a variety of counselors with different education and certification requirements.

Marketplace and insurance coverage

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Private insurance and Medicare dominate purchasing.

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State and local governments (including Medicaid) dominate purchasing.

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Care is typically covered by insurance. Copayments are lower, and more visits/days of care are covered.

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Insurance provides less coverage. Copayments are higher, and fewer visits/days of care and therapies are covered.

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Non-M/SU specialty care is purchased under the same contract as primary care.

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M/SU insurance coverage is purchased separately (“carved out”) from general health care.