APAPO CAPP meeting update: Using our strengths to position psychologists in the healthcare and prac
This week has been challenging but exciting: After 12 years in an integrated care program in bariatric surgery, I moved to a new position at the Cleveland Clinic Breast Center where I will be the first psychologist embedded there and developing a new behavioral health program. There are opportunities in the new position to grow something new, provide much needed services to a population, and work with a strong multidisciplinary team. However, there are challenges as well in navigating the politics between disciplines, gaining appropriate resources, coping with the politics and competing interests, and establishing the value of psychology on the team. It would be easy to get caught in the fear/anxiety of not being able to handle these challenges and react defensively; however, my approach is currently one of optimism, interest in teamwork, and curiosity the new environment that I will be adapting to as well as influencing. I am cautious but positive about my future.
In many ways, as I participated in APAPO CAPP this weekend, I feel like my career transition is a microcosm of changes facing the profession of psychology. We are at an important transformational point as a guild, and I feel that CAPP and the Practice Organization are working to approach our future with strength, teamwork, intentional positive influence over own destiny, and emphasis on the value that the profession of psychology brings to the healthcare field and larger practice world. I am hopeful that this vision will be one that focuses more on demonstrating our value as psychologists with a positive view on teamwork rather than one of competing for scarce resources and devaluing other professions. I am confident that as psychologists if we focus on our strengths and value, that we will assure our place in the healthcare field and practice world.
So how do we do this? APAPO priorities identified in the meeting included focus on Ps: payment, prestige (for psychology), products. Vehicles to deliver these goals included advocacy, focus on science/outcomes, and membership services. I think the single most important accomplishment at this meeting was something you will hopefully start to hear more about: the development of QCDR Qualified Clinical Data Registry by the APAPO. This is an initiative for psychologists to control their own future of outcome measurements, and it has the potential to not only help psychologists get better reimbursement (payment), but also be a member service (product), as well as a way to build a research basis for our value (prestige). I think it will also prove to be a source of non-dues revenue for the APAPO which will help with sustainability for the organization. In addition, being able to use outcome data for research on impact of psychological services can only help us with our advocacy efforts with Medicare such as physician definition and positioning ourselves in the new healthcare system.
What else did CAPP work on this weekend? Increasing the ease and value of Practice Organization membership is huge. You should have received your renewal email recently, and you’ll notice it’s easier to complete a one click there to the renewal page. If for someone reason, you didn’t get a renewal email, go here: https://my.apa.org/apa/idm/login.seam?ERIGHTS_TARGET=https://memforms.apa.org/apa/cli/dues/dues.cfm
Paper renewals will also be streamlined and out by the end of the month. I’ve been assured that APAPO membership for those APA members who choose this later will also be streamlined by November, including eliminating the need to call APAPO versus adding your Practice Organization membership online.
CAPP and the APA/APAPO Board are also examining new membership models to help keep the Practice Organization financially viable and models that enable members who wish to have primary membership in PO vs. APA or join one without the other. There are challenges to this, including c-3/c-6 issues, financial and legal implications. Many members still do not understand the difference between APA and the Practice Organization. It can’t be stated enough: APA cannot advocate on behalf of practicing psychologists or guild issues from a legal/tax status. Many psychologists assume that APA does this and are frustrated “why isn’t APA doing this or that?” However, it is the Practice Organization that supports the guild of professional psychologists. If you’re a practicing psychologist and want someone to fight for reimbursement, prestige, and provide products for practicing psychologists, you want to be a member of the Practice Organization.
Other hot topics at CAPP:
Membership
Practice guidelines for PTSD, depression and obesity are likely to be out by 2017
Look for new APAPO benefits including 5 free CE credits, webinars, updated Psychologist Locator
Valuable services: legal consultation, guide to Medicare, Innovative Practice Toolkits, Research Round Up
Good Practice will have a freshened look and include ECP column, State Beat column, legal corner, and quick polls.
Short term and long-term updates to the PO website to make it more user friendly
List-serv, take 2!
APAPO is working on re-launching its listserv this Fall. We believe this is an important two-way communication tool with Practice Organization members. It will be an opt-in list serv (you’ll have to sign up). You also will default reply to sender rather than reply all. We hope this will avoid some of the problems of our last launch (still have PTSD!). The great thing about an APAPO listserv is we can discuss advocacy issues in a way that is prohibited on APA list-servs. Some topics are likely to include reimbursement, integrated care, insurance issues, regulatory challenges, etc. You still will have to be careful about anti-trust and business promotion, but it should provide a great way to keep current with practice issues as well as provide feedback to APAPO about what is affecting you as a practitioner.
EPPP2
Feedback from students and ECPs was presented along with feedback from ASPPB. Student/ECP concerns included cost, burden, increased time to licensure, and sequence of training issues. ASPPB noted that competency based assessment is important to help psychology establish itself in healthcare arena and for future reimbursement. While competency based assessment is likely to be a more engaging process for students approaching licensure, it could be helpful to encourage sequence of training changes that would move EPPP1 up to the finish of coursework (graduate school); EPPP2 to end of internship, etc. CAPP will be discussing the EPPP2 in more detail at upcoming meetings. They encouraged ASPPB to do outreach to ECPs and students, in particular, to better explain what the licensure climate would be post EPPP-2 and to continue dialogue and engagement with ECPs and students.
Legal/Regulatory Victories
Successful Summits on Alternative Practice Models were held in Chicago & DC
Partnered with 9 SPTAs for Chicago and 7 for DC
Working to develop toolkit for spinoff conferences and 1-2 regional events for 2017 in new geographic areas
HIPAA update
Considering business plan regarding updating this important practice tool
Good progress on work with NY regarding fighting against exclusions for neuropsychological testing for patients with SMI and autism
Medicaid advocacy-working on intern reimbursement in several states
State Issues
Organizational development grants to continue. These are vital to keeping the doors open in several small states
SLC is now PLC—“Practice Leadership Conference.” Significant financial pressures have led to cost reduction, with institution of a $100 registration fee, hotel reimbursement reduction for FACs, EDs, CAPP; and replacement of the opening session with an evening reception on Saturday. Staff successfully renegotiated the hotel contract, and SPTAs will likely have increased cost sharing for the conference through the changes above. Kudos to APAPO staff for working to make PLC a continued strong leadership and advocacy opportunity for psychology despite challenges.
Government Relations
APAPO PAC did well with fundraising at convention: $27,000—thanks to all, especially improved leadership participation
Mental Health Reform bill has bipartisan support, and psychologists have done well advocating (sending emails/letters). Thank you!
Physician Definition bill needs CBO (Congressional Budget Office) score. Time is running short.
Goals to introduce early next Congress
Other issues include integrated care codes, testing codes, parity law enforcement
Encouraged mechanism to communicate more regularly (i.e., new listserv, social media, etc.)
Qualified Clinical Data Registry (QCDR)
Currently offering PQRS-PRO to our members to help with value based Medicare payment (i.e., report on measures to avoid penalties/bonuses). PQRS expires on Dec 31.
MIPS (Merit-Based Incentive Payment System) will replace PQRS and continue to focus on value vs. volume and will take effect for psychologists in 2019.
QCDR would be our own system we could use for MIPS. Will enable APAPO to pick 30 outcome measurements to follow.
Could be used to help negotiate with insurance issues, would have access to your own data
Data could be de-identified and used for research
MIPS reporting could result in -8% to +8% incentive payments for psychologists. Bottom line: your bottom line as a Medicare provider will be affected.
Could be marketed to other behavioral health providers
CAPP approved funds for start-up costs
CAPP Elections
Currently there is low participation rate in voting for your APAPO leaders; it’s open until September 30th. Please vote now! http://www.apapracticecentral.org/about/capp-elections.aspx
We discussed ways to make the elections more visible at Convention including a Meet the Candidates Forum
Discussed a shorter timeline for voting, more reminders to vote
Recommended using a matrix system to help look at APAPO priorities, competencies for slating
Center for Health
Applying for grant to train 6,000 psychologists in integrated care, value based models
Free 8 hour continuing education course, would work with SPTAs
Working on Diabetes training-2 hour CE will link to physicians who work with diabetes
Starting newsfeed on psychology and health
SPTAs and divisions—beneficial to hear about state healthcare reform and then disseminate as well
Policy
A motion to allow CAPP to originate policy (reviewed by APAPO Board, Finance and General Counsel) was passed
As an example, a workgroup was formed to make a companion policy on integrated care to the one approved by APA Council.
Divisions
APAPO is reaching out to divisions regarding collaboration, particularly for APA convention programming
Wow! I’m tired after reading all that much less being there. Seriously, it was a very full meeting, but so important. The members of CAPP, CAPP liaisons, APAPO Board, and APAPO Staff are a wonderful group to work with, and I’m learning so much from each of them. I’m sure I missed other important information, so stay tuned for the official minutes. The last important news is that apparently CAPP will be moving to one in-person meeting per year, with the rest of the work done in virtual meetings due to budgetary restraints. As of now, this meeting is tentatively scheduled for October 12-15, and CAPP will also meet at PLC on March 6th for a half day.
What are your take-aways? APAPO CAPP is working hard to promote the profession of psychology and maintain a positive vision where psychology has a strong place in the healthcare and practice marketplace. They are focused on increasing recognition of your worth as psychologists, promoting policies that will give you better payment for your services, and providing services that you need to function as a practitioner. I am grateful to be part of the APAPO; I know as a practitioner how vital it is to have the advocacy, regulatory assistance, and services APAPO provides me every day. I am privileged to be able to use these APAPO benefits to help me in my new position. As I move forward with new challenges, I am excited about my professional future and the future of all psychologists.
*As a reminder, this blog is not an official APAPO or CAPP communication. This is my personal take on APAPO/CAPP activities. My goal is to provide timely and transparent information on APAPO/CAPP to APAPO members.
