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Half of Psychiatrists Do Not Accept Insurance

Access to mental health care is a growing issue in the United States. About 58 million Americans suffer from a mental illness, but many of those 58 million do not seek or cannot gain access to professional help or services. Partly due to the increase in violent attacks by mentally ill individuals, the government has recently gotten more involved in improving access to care through funding for mental health services and raising awareness.

Despite the efforts to increase access to psychiatric care, about half of all psychiatrists reject insurance, leaving many Americans without the monetary means to receive professional psychiatric services. A recent study published in JAMA Psychiatry by researchers at Weill Cornell Medical College found that only 55 percent of psychiatrists accepted private insurance or Medicare and only 43 percent accepted Medicaid between 2009 and 2010. Since 2005, psychiatrists who accept private insurance decreased by 17 percent and those who accept Medicare decreased by 19.5 percent, dramatically lower than the 86 percent acceptance rate of other specialties.

"In the current climate, where the need for increased mental health services is now recognized, I suspect our study conclusions will be an eye opener for both the public and medical community," says Dr. Tara F. Bishop, the lead author of the study.                     

The increasing demand for psychiatric services combined with the decrease of available psychiatrists enables practitioners to charge more for services and demand cash. If patients can't afford to see a psychiatrist, they often instead turn to primary care physicians for mental health services. There is also a shortage of primary care doctors, so these offices are flooded by mentally ill patients needing specialized care that should be taken care of in a psychiatrist's office.

The researchers of the study say incentives need to be provided to medical students to pursue a degree in psychiatry as the number of students entering the field dwindles and more psychiatrists are retiring.

Another major cause of psychiatrists choosing to reject insurance could be due to the reimbursement rates for services, which providers may feel are too low for the amount of time and care put into each patient. Psychiatrists see fewer patients in a day than other specialists, so can receive less reimbursement for their services.  Hopefully this will improve with the new higher work values for psychiatry codes the Centers for Medicare and Medicaid Services recently adopted.