Healthcare Reform Are neuropsychologists at the Table?
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Transcript of Healthcare Reform Are neuropsychologists at the Table?
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KAREN POSTAL PH.D., ABPP-CN
C H A I R O F P R A C T I C E , A M E R I C A N A C A D E M Y O F C L I N I C A L N E U R O P S Y C H O L O G Y
KATHERINE NORDAL, PH.D.
E X E C U T I V E D I R E C T O RA PA P R A C T I C E O R G A N I Z AT I O N
Healthcare ReformAre neuropsychologists at the
Table?
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Timeline of Changes:
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Medicare is ChangingPRIOR: PAY PER PROCEDURE
NOW: INCENTIVE LESS CARE/ QUALITY
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Now.
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Timeline PPACA
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The supreme court decision is not stopping that train.
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U.S Healthcare system
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Private Insurance is Changing
PRIOR: PAY PER PROCEDURE
NOW: INCENTIVE LESS CARE/ QUALITY
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Private insurers are rapidly moving towards global payments and ACOs
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Why do private insurers love Global Payments?
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REIMBURSEMENTS ARE TIED TOREDUCTIONS IN THE TOTAL COST OF
CARE FOR A POPULATION OF PATIENTS.
(AS LONG AS QUALITY MARKERS ARE MET)
accountable care organizations (ACOs)
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Medicare ACO Quality Measures
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MEDICARE PROFESSIONALS MD DOPANP
CNS
OTHER ENTITIES MAY JOIN THE GROUPS AS “PARTICIPANTS”
Who shares in the incentives?
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THE ACO KNOWS EXACTLY WHAT EACH DOCTOR IS BILLING
ACOs Tools to Control Costs
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Thought Experiment
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Current common referral patterns
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Fundamental shift in our professional identity
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PATIENTS HEALTH
AND HEALTHCARE COSTS.
This means neuropsychologists have to
own
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• TREAT MEDICATION NON-COMPLIANCE AS A CRISIS?
•UTILIZE PSYCHOLOGICAL AND COGNITIVE DATA TO DEVELOP AN ACTION PLAN TO ADDRESS THEIR MAJOR HEALTH ISSUES?
• Diabetes action plan: blood monitoring and diet• Heart disease action plan: exercise• Asthma management (often family systems intervention)
How many neuropsychologists
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•IDENTIFY AND DEVELOP A RELATIONSHIP WITH LOCAL ACO(S)
•EFFECTIVELY COMMUNICATE HOW NEUROPSYCH ASSESSMENTS WILL HELP THEM LOWER COSTS/ IMPROVE QUALITY
•SUPPORT APA PRACTICE ORGANIZATION/ ADVOCACY FOR MORE FAVORABLE RULES
Who will succeed? Neuropsychologists who: