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?       

Timeline of Changes:

Medicare is ChangingPRIOR: PAY PER PROCEDURE

NOW: INCENTIVE LESS CARE/ QUALITY

Now.

Timeline PPACA

The supreme court decision is not stopping that train.

U.S Healthcare system

Private Insurance is Changing

PRIOR: PAY PER PROCEDURE

NOW: INCENTIVE LESS CARE/ QUALITY

Private insurers are rapidly moving towards global payments and ACOs

Why do private insurers love Global Payments?

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)

Medicare ACO Quality Measures

MEDICARE PROFESSIONALS MD DOPANP

CNS

OTHER ENTITIES MAY JOIN THE GROUPS AS “PARTICIPANTS”

Who shares in the incentives?

THE ACO KNOWS EXACTLY WHAT EACH DOCTOR IS BILLING

ACOs Tools to Control Costs

Thought Experiment

Current common referral patterns

$

$

$

$

Fundamental shift in our professional identity

PATIENTS HEALTH

AND HEALTHCARE COSTS.

This means neuropsychologists have to

own

• 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

•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: