Recently there was a lengthy discussion of payments rates for clinical social workers on the NASW Community Forum and enjoyed reading all the comments and agreed with many of them!
For what is it worth, I am in private practice. However, I have worked for a profit and non-profit employers and a managed care company.
We all know the health care system is fragmented despite the ACA. We have profit and non-profit insurance companies; we have government programs who contract with insurance companies for Medicare and Medicaid; we have employer-sponsored insurance plans and individual insurance plans. The payment space is a mess and very convoluted with clearinghouses and others wanting their piece of the money pie.
Three core factors must be considered in the discussion of the payment system for clinical social workers. We live in a capitalistic economy, and I do not see that even changing so we must find a way to negotiate within it for reasonable payments. The second is related. NASW has a specific structure as a professional organization. Even though we are members and we are also all independent business entities or work for independent business entities both private and public, in our business economy. I am not sure how NASW as currently structured could be effective in the business environment, which is not to say that I would not want them to be, and why they have not been “at the table.” The third factor is that the political will of the people has not yet solidified to the point of electing legislators at the state and federal levels to focus on a long-term solution.