Can the trend toward prospective payment systems benefit psychologists in any foreseeable way?
Yes, beginning July 1998 and phased in over the next three years, skilled nursing homes will be receiving more of their federal funding based upon the acuity level of their residents. Acuity levels are determined based on Resource Utilization Groups (RUGS), the nursing home equivalent of Diagnostic Related Groups (DRG s), used in acute care settings. Ratings of mood and behavior play a role in determining a patient s RUG s score. Identified psychological problems at the time of admission can ostensibly impact the rating of patient acuity and therefore result in higher payment to the facility. Because Medicare Part B does not pay for “fishing expeditions” or routine psychological consults on new admissions, it would appear to be in the best financial interest of the institution to pay behavioral health providers to perform screening evaluations as patients are admitted. This may be a new avenue of employment opportunity for psychologists skilled in geropsychological assessments. Paula H
