Problems and limitations in using psychological assessment in the contemporary health care delivery system.

Abstract

Psychologists report limitations on psychological assessment services and problems gaining authorizations and reimbursement for these services from third-party payers. Documentation and categorization of these problems and limitations is based on responses from well over 500 psychologists responding to a broad solicitation for feedback. This article explores the barriers to access for assessment services, including resistance to psychological assessment, difficulties in the preauthorization process, problems with reimbursement, the clinical decision-making process, and larger systems issues. The authors make recommendations for redress of these problems through work with the profession, other mental health professionals, managed care, and patients-consumers and through political action. Psychological and neuropsychological assessment services are under assault from organized health care delivery systems, managed mental health care organizations, and health care payers. As a profession, psychology must respond to this attack with advocacy and a credible explanation of the value and usefulness of assessment if it is to survive as a covered health care service. This article reviews issues in the current applications of psychological assessment in health care settings and recommends appropriate responses. The message from health care delivery systems is clear. Critics argue that psychological assessment is time consuming, expensive, ELENA J. EISMAN received her EdD in 1975 from Boston University. She is currently the executive director of the Massachusetts Psychological Association and a faculty member at the Massachusetts School of Professional Psychology. She maintains an independent practice in Newton Highlands, MA.

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