Section 17. Impacts of Managed Care on Net Income Since 1996
This section addresses the impact that managed care and other changes in the health care system have had on net income since 1996 for doctoral-level, independent practitioners. "Independent practitioners," in this case, primarily refers to licensed clinical, counseling, and school psychologists who are involved in full-time individual, group, or medical-psychological group practices.
Table 17.A illustrates, by years of experience, the percentage of independent practitioners who have undergone a salary increase or decrease as a result of managed care, and those who have not experienced any noticeable flux in income. The majority of independent practitioners (58%) reported experiencing a decrease in salary due to the changes in the health care system. Just under 6% of these psychologists reported an increase in salary, while approximately 36% acknowledged that they did not experience any measurable impact on salary as a result of managed care. In general, those practitioners who had more years of experience were more apt to report a negative impact due to managed care. About 63% of those practitioners who had over 10 years of experience reported a decrease in income since 1996. Fifty-five percent of practitioners with 5-10 years of experience revealed that they are earning considerably less than the previous year. Last, 38% of practitioners with less than 5 years of experience underwent a decrease in salary. Although salary increases were generally less common, those practitioners with more years of experience were less likely to enjoy the benefit of an increased salary as a result of changes in the health care system.
Table 17.B presents the actual percentage of change in net income as a result of managed care. Overall, independent practitioners underwent a median decrease and a median increase in net income of 15% and 10%, respectively. One noteworthy finding was that practitioners with less than 5 years of experience enjoyed a median salary increase of 40%, exceeding all other groups of practitioners.
In comparison, the impacts of changes in the health care system on salary since 1996 are fairly similar to the changes reported between 1994 and 1995. That is, in 1995, practitioners with more years of experience also were more likely to report a negative impact due to managed care. Furthermore, for the most part, the percentage of change in income since 1996 was comparable to those reported between 1994 and 1995. The slight differences that exist between 1996-1997 and 1994-1995 may not be substantive.