Resolution on Psychologists in Integrated Primary Care and Specialty Health Care Settings


INTEGRATED CARE, QUALITY IMPROVEMENT



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INTEGRATED CARE, QUALITY IMPROVEMENT,

AND OUTCOME MEASUREMENT
Impact of healthcare reform on payment systems.
Even with changes in the political climate, healthcare reform efforts in the United States will continue to significantly impact psychologists practicing in integrated care settings. Integrated care psychologists, like their counterparts in independent practice, have been dependent on fee for service payment. The Patient Protection and Affordable Care Act (PPACA) (2010) created service delivery, financing and reimbursement models which move away from fee for service payment to a model that utilizes bundled payments to incentivize improved health outcomes and quality of care at lower costs (Nordal, 2012). Private insurers and healthcare systems also have been moving toward value based payment, and are likely to continue to do so even in a changed political climate (Morse, 2017). This change toward value-based reimbursement is likely to impact psychologists in integrated care settings, (Nordal, 2012). Psychologists in integrated care settings are at risk for being excluded from reimbursement through bundled payments because existing reimbursement mechanisms do not typically include ability to reimburse integrated behavioral health or neuropsychological assessment, treatment, consultation. Without CPT codes reflecting psychologists role integrated care, it is impossible to place value on their work, and thus to allocate a portion of the bundled payment for psychological services.




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