a barrier to addressing psychosocial issues (Astin et al., 2006). Reimbursement policies could be structured in ways that would reward providers with the best performance in communicating with patients.
Policies Addressing the Identification of Psychosocial Needs
As discussed in Chapter 4, two general means are used to identify patients’ psychosocial needs reliably: screening for problems, followed by an assessment, or bypassing screening and conducting a more comprehensive assessment by itself. Given the brevity of several reliable and valid screening instruments (as discussed in Chapter 4) and the fact that many of these instruments can be self-administered by the patient (often in the waiting room prior to contact with the physician, also as discussed in Chapter 4), the resources required to administer such instruments may not be substantial, although following up on numerous, complex needs thus identified may be, as discussed below.
Although FFS Medicare generally does not pay explicitly and separately for screening services (except when coverage for a specific screening