The managed care movement

The managed care movement has an impact on psychological assessment since managed care companies (MCOs) often provide reimbursement for testing costs. Werthman (1995) notes that previously psychologists had free rein in terms of what tests as well as how many tests were administered to aid in diagnosing a client’s condition. More recently, managed care has required mental health professionals to restrain their use of tests to those few that seem most appropriate based on the individual case. Some MCOs have developed very specific protocols for the use of certain psychological tests (Sipkoff & Oss, 1995). Value Behavioral Health, one of the largest MCOs in the country, has specified guidelines for several major categories of tests. For example, in order to be deemed medically necessary, a personality inventory, “…should provide what an effective clinical interview cannot.” (as cited in Sipkoff & Oss, 1995). In some instances, the rationale for not reimbursing certain assessments lies in the prognosis. Werthman (1995) points out that, in many cases, MCOs will not certify certain types of testing for individuals with Axis II disorders because these disorders are “extremely treatment-resistant.” Werthman (1995) points out that the situation becomes murkier when dealing with clients whose conditions may be the result of psychological factors or organic conditions. In any event, there is a need for clinicians to develop clear and specific ideas regarding the nature of a client’s problem even before assessment begins.

  1. Provide an opinion on this issue.
  2. Can you understand both sides of the issue?
    3.. What impact do you think there will be if similar things occur with universal health care?

Sources: Sipkoff, M. & Oss, M. E. (1995, Sept-Oct.). Value Behavioral Health’s protocol’s for psychological testing. Behavioral Health
Management, 3, p. 27. Werthman, M. J. (1995, Sept-Oct). A managed care approach to psychological testing: Far from discounting psychological testing entirely, managed care can enhance its therapeutic usefulness. Behavioral Health Management, 3, p. 15.

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