The Register Report, Spring 2006: A Special Report on Developmental Challenges A Model of Service Delivery: Meeting the Behavioral Healthcare Needs of Community Residing Older Adults by: Paula Hartman-Stein, Ph.D. and Leslie McClure, Psy.D. Return to Table of Contents

Demographic changes, restrictive rules for inclusion in managed healthcare insurance panels, and improvements in Medicare reimbursement are powerful factors attracting ever increasing numbers of psychologists in the United States to work with older adults. Current population trends are responsible for a pool of older clients; e.g., in 2006 the first of the Baby Boom generation meets the age requirement to enroll in Medicare as their primary healthcare plan. Recent census data indicate the fastest growing age group is the older adult age 85 and beyond. Directly linked to this group are adult children and family caregivers who seek psychological services and consultations for themselves as well as their parents. Also impacting psychology practice patterns are managed healthcare regulations that limit access to younger patients by restricting provider enrollment in many managed care panels, making it unlikely for new psychologists to participate. Added to the mix are low reimbursement rates from managed care plans, cutbacks in state Medicaid reimbursement for mental health services, and greater competition from other mental health professionals to provide assessment and psychotherapy. Such economic forces make it increasingly likely that larger numbers of psychologists who work in traditional private practice as well as integrated primary care settings will welcome referrals for older adults and consider marketing their services to this age group.

This paper illustrates a model of service delivery designed to meet the behavioral healthcare needs of community-residing older adults and their family members in a mid sized town in northeast Ohio. Founded by the senior author more than 12 years ago, the Center for Healthy Aging is a free-standing niche private practice with no outside funding. The center is modest in size, currently staffed with two full time clinical psychologists with a geropsychology specialty, one part-time therapist and occasional medical students or psychology trainees assisting in patient care. We offer focused, cost-effective behavioral health services that have proven to be well accepted by the consumer and are in compliance with Medicare and other third party payer regulations.

The array of services provided at our center includes cognitive/memory evaluations; individual, couple, and group psychotherapy; family consultations; health and behavior interventions; cognitive fitness/memory enhancement classes; and consultation and training programs for professionals. By working closely with local primary care physicians, we believe this is a service delivery model that can operate and thrive in many communities. The types of services illustrate opportunities open to psychologists who wish to expand their work to older adults, either as an adjunct to a general private mental health practice or by offering services to primary care practitioners in their offices. continued

Page 1

Page 1 2 3 4 5 6 7 8 9 10 11 12