Date of Award
Spring 5-2026
Document Type
Dissertation
Degree Name
D.S.W. Social work
Department
Social Work
First Advisor
Yasoda Sharma, MSW, PhD
Second Advisor
Christopher Harris, PhD
Third Advisor
Leslie M Chaundy, LCSW, PSYD, NCSP, ABSNP
Abstract
Licensed Clinical Social Workers (LCSWs) in private practice in Pennsylvania make critical decisions regarding the populations they serve and the type of insurance to be credentialed with. Current research shows there is minimal participation among Medicare insurance plans, both traditional Medicare and Medicare Advantage plans, with mental health practitioners and minimal research centers from the perspectives of LCSWs. The findings from a mixed-methods dissertation study that examines Pennsylvania LCSWs' experiences working with Medicare beneficiaries and the factors that influence the decision to accept or opt out of Medicare.
A self-administered questionnaire has been completed to obtain quantitative data and 92 Licensed Clinical Social Workers who own their own practice in Pennsylvania completed it. The survey completed by LCSWs included demographic information, practice characteristics, and Medicare participation. Chi-square and cross-tabulation analyses were conducted to determine the relationship between geographical location (rural, urban, mixed) and Medicare acceptance among LCSWs within private practice. Results of the analysis indicated a statistically significant relationship between geographical location and Medicare acceptance, χ²(2, N = 92) = 19.47, p < .001.
Through open-ended survey responses (n=92) and semi-structured interviews (n=5), data were collected to determine experiences with Medicare insurance plans. Reflexive thematic analysis was used to analyze the data, with an ecological framework guiding it. Themes have emerged that explored significant administrative burden, credentialing challenges, and reimbursement and billing complexities when accepting Medicare plans, particularly Medicare Advantage. Clinician preference, along with broad structural and administrative constraints, determines Medicare acceptance among LCSWs in private practice. The study provides implications for policy reform, advocacy, and sustainable practices that will be reviewed.
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Kioske, Stevie N., "Pennsylvania Licensed Clinical Social Workers’ Experiences with Medicare Insurance Plans within Private Practice" (2026). Social Work Doctoral Dissertations. 50.
https://research.library.kutztown.edu/socialworkdissertations/50
