Every year for the past 30 years, APA has brought together representatives of state, provincial, and territorial associations for leadership and advocacy training.  This year’s State Leadership Conference (SLC) took place in Washington, D.C. from March 9-12 with the theme of Countdown to Health Care Reform.  Seventy-five SPTAs and APA divisions were represented as well as diversity delegates, early career psychologist delegates, and representatives of the American Psychological Association of Graduate Students.

MPA sent five delegates to SLC:  Tabitha Grier-Reed, Ph.D., President; Steve Vincent, Ph.D., President-Elect; Mera Kachgal, Ph.D., Diversity Delegate and MPA Secretary; Sy Gross, Ph.D., Federal Advocacy Coordinator; and, Jenna Bemis, Psy.D., Public Education Campaign Coordinator.

Consistent with the theme of Countdown to Health Care Reform, topics covered at the conference ranged over a wide array of reform and practice topics, and in future Minnesota Psychologist issues I may report on others, but for now I want to highlight two that are both important and not widely known among psychologists.

PQRS

In 2007, Medicare instituted the Physician Quality Reporting Initiative (PQRI), which paid providers an incentive for gathering and reporting quality measures.  The incentive payments have been added to Medicare payments for all eligible providers who reported these measures.  Reporting was all that was required – that is, no quality targets had to be met.

PQRI has changed to PQRS, Physician Quality Reporting System, and in 2015 PQRS changes from a carrot to a stick.  What has become an incentive for quality reporting measures will be a penalty for not reporting – a penalty in the form of decreased Medicare payments.  Details of PQRS, including measures applicable to psychologists, are available at the homepage of PQRS.

Psychologists who are Medicare providers are “eligible providers” under PQRS.  If you are not a Medicare provider, you will not be impacted by PQRS – at least for now.  However, since Medicare is generally the trendsetter among third party payers, and since PQRS is an example of the kind of quality reporting that will be an element of future healthcare delivery systems, it would be helpful for psychologists to be informed about PQRS, whether working for an agency or in private practice.

Physician Definition

Ironically, while Medicare defines psychologists as “eligible providers” for the Physician Quality Reporting System, making psychologists eligible for payment penalties, Medicare does not include psychologists in the definition of “physician.”  Medicare does include dentists, podiatrists, optometrists, and chiropractors in the definition.  Changing this literally requires an act of congress, and passage of such an act has been a major legislative initiative of APA for several years.

Passage would not change psychologists’ scope of practice, and obviously would not make psychologists actual physicians, but would allow psychologists to function within their scope of practice and fill roles such as directing partial hospitalization programs.  Also, if psychologists were included in the physician definition, they would be eligible to collect incentive payments for adopting electronic health records, which would help to offset the cost of such systems.  A bill currently introduced, HR 794, would include psychologists in Medicare’s physician definition. If you have a chance to communicate with your member of Congress, with Senator Klobuchar or Senator Franken, or with any of their staff members, please ask them to sign on as co-sponsors of HR 794.

Big Changes are Under Way

The Countdown to the Health Care Reform theme of the SLC implies that changes are coming, but, in fact, changes have already begun and are accelerating. They will impact all aspects of the American healthcare system and all providers of healthcare.  Stay tuned to MPA and APA to learn more, and seize the opportunity to get involved in shaping the future.

Steven M. Vincent, Ph.D., L.P., is the Director of Behavioral Health Services, CentraCare Health System ([email protected]).  Dr. Vincent is the current president-elect of MPA, having served two terms on the Governing Council from 2003 to 2009, and as a Legislative Committee Chair from 2004-2012.   Steve was also on the Governing Council of the American Hospital Association Section on Psychiatric and Substance Abuse services from 2010 through 2012.  He is the founding chair of the Minnesota Hospital Associations Mental Health Task Force.