title: Use of nonphysician providers in the Medicare program: assessment of The Direct Reimbursement of Clinical Social Workers Demonstration Project.
abstract: Rising Medicare costs and concern about inadequate access to physician services have prompted interest in extending independent practitioner status to nonphysician providers. This paper reviews the findings from a demonstration project that tested whether recognizing clinical social workers (CSWs) as independent practitioners in the Medicare program would be a cost-effective method to improve access to needed mental health services. The demonstration showed little impact on access and no clear evidence of savings, despite the lower cost of CSW services compared with those of psychiatrists. Differences between CSWs and psychiatrists in treatment patterns and treatment settings, however, suggested that for some patients CSWs might be an appropriate alternative source of care.
authors.forename: S
authors.initials: S
authors.lastname: Haber
authors.forename: N
authors.initials: N
authors.lastname: McCall
mesh_terms: D000368:Aged; D002140:California; D014487:Centers for Medicare and Medicaid Services, U.S.; D005249:Fees and Charges; D005260:Female; D006801:Humans; D007349:Insurance, Health, Reimbursement; D008297:Male; D006278:Medicare / Q000191:economics*; D008605:Mental Health Services / Q000706:statistics & numerical data; D012949:Social Work, Psychiatric / Q000191:economics* / Q000706:statistics & numerical data; D014481:United States