Complexity and Provider Revenue Module

Daniel Michalski, Tanya Mulvey, and Jessica Kohout
APA Center for Workforce Studies
May 2010

Main Report: 2008 APA Survey of Psychology Health Service Providers

Module A: Doctoral Internship
Module B: Insurance
Module C: Client Complexity and Provider Revenue
Module D: Information on Telepsychology, Medication and Collaboration
Report Text

The Complexity and Provider Revenue survey module was completed by 2,388 respondents. This section focuses on the results from those participating in this survey module. The three questions constituting the complexity survey module were given to all participants of the paper survey distribution and a random selection of online respondents.

Note: This module report was not previously released as a separate information brief.

Module Results

Table 1 reveals health service providers’ perceptions about the complexity of their caseloads. More than one half (53 percent) of respondents indicated that their caseloads have become more complex during the course of their career while 40 percent believe their caseload’s complexity has remained the same. Less than one tenth (6 percent) believed their caseload has become less complex over the years.

Table 2 summarizes the ways in which providers’ caseloads have increased in complexity. Totals sum greater than 100 percent as respondents could select more than one option. Slightly more than one quarter (26 percent) indicated that their caseload has become more complex due to more complex social/environmental situations. Twenty-once percent attributed increased caseload complexity to more comorbid Axis I disorders while 20 percent specified more severe Axis I and Axis II disorders as contributors to caseload complexity.

Table 3 examines the sources of revenue for psychology health service providers. An average of 30 percent of revenue (SD=42.73) for health service providers came from salary. Subsequently, an average of 27 percent of revenue (SD=32.38) was obtained through private insurance payments. Participation in government insurance programs (Medicare, Medicaid, Tricare) constituted an average of 11 percent of revenue amongst respondents. (See Insurance Module report section for further information). It is important to note that the 19 percent attributed to Self pay as a revenue source may include those in private practice paying themselves a salary from their incorporated business or provision of services through a nonregistered corporate entity.