APA Practice Organization advocates for professional psychology with US Senate chronic care working group

The letter addressed integrated care, access to telehealth services, evidenced-based treatments for obesity and more.

With Medicare beneficiary enrollment on the rise, Congress is concerned with improving care and streamlining costs. An estimated 68 percent of adults with mental disorders have comorbid medical conditions, and 29 percent of adults with medical conditions have a mental health disorder. The APA Practice Organization (APAPO) is advocating for access to psychological services for these patients.

On Jan. 26, the Practice Organization responded to the "United States Senate Committee on Finance Bipartisan Chronic Care Working Group Policy Options Document," a continuing effort that began in 2014. In the letter to the working group co-chairs Sens. Johnny Isakson, R-Ga., and Mark Warner, D-Va., APAPO applauded the working group’s recognition of the critical importance of mental and behavioral health care in addressing the health care needs of Medicare beneficiaries.

The chronic care working group was formed in May 2015 to analyze current law, discuss alternative policy options and develop bipartisan legislative solutions to improve care for Medicare patients with chronic conditions. In June, APAPO submitted a letter (PDF, 167KB) in response to the working group’s initial request for policy proposals. Following the submission of stakeholder comments and congressional hearings, the working group released a policy options document (PDF, 446KB) on policies it is considering and requested additional comments.

The working group has recognized that the Medicare program must better address the high rates of comorbidity of mental disorders with chronic medical conditions, and the Practice Organization offered in its comments additional steps and policy proposals to improve access to quality and effective mental health services for Medicare beneficiaries with chronic conditions, and to help further the integration of mental health services within the health care service delivery system.

Highlights of APAPO’s suggestions are listed below. Read the full letter from APAPO (PDF, 259KB) online. 

  1. Address the need for behavioral health among chronically ill beneficiaries by eliminating unnecessary requirements that hinder access to psychologists’ services.
  2. Fully integrate health and mental health services and include multi-professional care.
  3. Improve care management services for individuals with multiple chronic conditions by allowing appropriate psychologist reimbursement.
  4. Include psychologists in the expanded Independence at Home model of care.
  5. Make psychologists eligible for incentives for the adoption of electronic health records.
  6. Eliminate barriers to important telehealth services.
  7. Consider additional evidence-based obesity treatments, including mental and behavioral interventions.
  8. Allow psychologists to provide their services to beneficiaries in a one-time visit, post initial diagnosis of Alzheimer’s/dementia or other serious life threatening illness.
  9. Adjust Medicare payment formula to end erosion of payments for psychologists.

The Practice Organization will continue to work with Congress to support professional practice and the availability of psychological services for Medicare beneficiaries with chronic conditions.