Practical and ethical assessment issues in rural, impoverished, and managed care settings.

Abstract

The rising costs of new psychological tests, increased frequency of test revisions, and difficulty receiving authorization and reimbursement from managed care companies make it increasingly difficult for practitioners to provide the best standard of care to clients when conducting psychological and neuropsychological assessments. Practitioners, especially those in low-income and rural areas, may struggle with handling these practical realities while maintaining ethical standards in conducting psychological assessment. Suggestions for how to manage practical challenges faced by practitioners who provide psychological assessments, such as selecting tests when authorization or reimbursement by a third-party payer is restricted or denied, purchasing psychological tests on a budget, and providing assessments with a limited number of qualified staff are discussed. The authors also provide recommendations for the future prevention of these challenges through work with test developers, test publishing corporations, third-party payers, political action groups, and the psychology profession itself.