Membership in ACOs

How do neuropsychologists join ACOs and Medical Homes?

The federal Affordable Care Act statute specifically defines the professionals who can form Accountable Care Organizations in the context of Medicare/ Medicaid reimbursement:  

• MDs, 
• DOs, 
• Physician Assistants, 
• Nurse Practitioners, 
• Clinical Nurse Specialists. 
  

Psychologists are not included in the list of “Medicare Professionals.”  However, we can join Medicare/ Medicaid ACOs as "participants."  Advocacy efforts are underway to change the federal statute to include psychologists.  In the meantime, there are three ways psychologists and neuropsychologists are interacting with ACOs. 

1. As staff members in organizations that have formed into ACOs

Neuropsychologists who are on staff with hospitals or large group practices that form into ACOs or medical homes automatically become ACO participants.  In the innovative practice model section of the website, read the interview with Pete Duquette, Ph.D., who is on staff of an ACO, and Leslie Bourne, Ph.D., who is the Director of Behavioral Health at a large health system. 

2.  As independent contractors

Some psychologists with large group practices are contracting with ACO systems to "carve out" behavioral health services on a per patient, per month basis. In the innovative practice model section of the website, read the interview with Michael Goldberg, Ph.D., who has contracted with ACOs for delivery of neuropsychological and psychological services.

3.  As independent practitioners in the community, separate from the ACO structure, but with a formal or informal referral relationship

Neuropsychologists may receive referrals from medical homes and ACOs without formal membership.  Some have specifically sought out ACO professionals and pitched their services, making a case for why they, more so than other neuropsychologists in the area, can provide cost effective, high quality assessments.