Raising Access Questions, Many Psychiatrists Demand Cash
Psychiatrists, who are often relied on by individuals with developmental disabilities, are less likely than other doctors to accept insurance, a new study finds.
Slightly more than half of psychiatrists said they accepted private insurance in 2009-2010. A similar number took Medicare but even less — 43 percent — accepted Medicaid.
The findings come from an analysis of a nationally-representative survey of doctors that’s conducted annually by the U.S. Centers for Disease Control’s National Center for Health Statistics. Each year about 1,250 doctors are polled, some 5.5 percent of whom are psychiatrists.
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“More than physicians in other specialties, psychiatrists accept lower rates of insurance, and those who don’t take insurance are likely charging cash for their services,” said Tara Bishop, an assistant professor at Weill Cornell Medical College who led the study published this month in JAMA Psychiatry.
“I suspect our study conclusions will be an eye opener for both the public and the medical community,” Bishop said. “No prior studies have documented such striking differences in insurance acceptance rates by psychiatrists and physicians of other specialties — primarily because no one has looked closely at the issue.”
The number of psychiatrists accepting private insurance fell by about 17 percent between 2005 and 2010, the study found.
While about half of psychiatrists took payment from insurers in 2010, the researchers indicated that nearly 90 percent of other physicians did.
The survey did not address why fewer psychiatrists are accepting insurance. But Bishop speculated that with counseling and therapy often taking more time than other types of medical services, psychiatrists may be unable to see as many patients each day as other specialists and may not feel adequately compensated by insurers.
What’s more, Bishop added that psychiatrists are more likely than other doctors to have solo practices making the administrative work required to process insurance claims potentially burdensome.
Meanwhile, researchers said, the number of practicing psychiatrists is also on the decline, dropping 14 percent between 2000 and 2008, further exacerbating concerns about access to care.