At its August 2017 meeting the Council of Representatives of the American Psychological Association (APA) approved a seven-year renewal of geropsychology as a recognized specialty in professional psychology.
Victor Molinari, Ph.D., professor at the University of South Florida, said a primary benefit of the specialty recognition is to raise the profile of the field by alerting the community there is a body of knowledge and skills including training models and programs for providing services to older adults.
The practical benefits of board certification to individual psychologists who work in the geriatric area are debatable, especially for newly licensed clinicians who have heavy graduate school debt to pay.
“With health care in such an unstable environment in our country, asking people to pay for specialty training may not be a good investment,” said John Caccavale, Ph.D., executive director of the National Alliance of Professional Psychology Providers.
The initial cost of application and testing for geropsychology board certification is $825 with an additional $185 annually, plus travel costs to the testing sites. Currently the exams are scheduled twice a year, at the annual conventions of the APA and the Gerontological Society of America.
In an email interview, Molinari who spearheaded the recent renewal process for geropsychology, said that psychologists who work with older adults may need to obtain board certification in order to be hired in settings such as the Mayo Clinic or to obtain raises in the Veterans Administration.
He said specialization in psychology is becoming the rule rather than the exception, similar to subspecialties in the medical field. “In the future, Ph.D. professional psychologists will be expected to specialize.”
An argument against psychology specialization includes the growing trend of future employment opportunities for psychologists to work within primary care settings where they have a generalist role, similar to that of primary care physicians.
“Over the last two years,” Molinari said, “I have attended three specialty summits and one post-doctoral summit. All the major players have come to agreement that we need to use uniform terminology to define what a specialty is, to agree on one list of designated specialties across varied constituencies and to describe the content of training programs to allow incoming students to plan their specialty trajectory.”
He said the specialty status and its renewal by APA paved the way for the board of professional psychology to credential individual psychologists who have gained competence in the foundational and functional domains necessary to provide services to older adults.
The American Psychological Association Practice Organization (APAPO) is working to increase reimbursement potential for psychologists who work with Medicare beneficiaries by advocating that all psychologists, regardless of size of their practices, be given the option of participating under the Merit Based Incentive Payment System (MIPS) in future years.
Diane Pedulla, director of regulatory affairs of APAPO, said in a recent webinar that this would allow them to be eligible for bonus payments ranging from 4 percent to 9 percent by 2022.
Restricting Medicare providers to only those who are board certified would require a major change in federal regulations and would make it less likely that individuals age 65 or older could receive behavioral health care services because of an insufficient number of clinicians to meet the needs of the growing Medicare population.
Paula Hartman-Stein, Ph.D., is a psychologist and behavioral health care consultant who has served on quality measure panels for CMS and who produces educational videos on Medicare compliance and curriculum for wellness groups to enhance memory and mood of older adults. Her website is www.centerforhealthyaging.com.