Featured Research

from universities, journals, and other organizations

Half of psychiatrists reject private, federal insurance, preferring cash, study shows

Date:
December 12, 2013
Source:
Weill Cornell Medical College
Summary:
Access to mental health care has become a prominent issue in Congress following mass shootings around the United States. But a new study suggests that unless those in need of help have deep pockets, they might have a hard time finding a psychiatrist that will provide the needed services.

Access to mental health care has become a prominent issue in Congress following mass shootings around the country. But a new study in JAMA Psychiatry, led by researchers at Weill Cornell Medical College, suggests that unless those in need of help have deep pockets, they might have a hard time finding a psychiatrist that will provide the needed services.

Related Articles


The study found that psychiatrists increasingly refuse to accept Medicare and Medicaid, or even private insurance, as payment. In the five years between 2005 and 2010, investigators found that the percentage of psychiatrists who accepted private insurance dropped by 17 percent, to 55 percent, and those that took Medicare declined by almost 20 percent, also to about 55 percent. Their acceptance of Medicaid is 43 percent, the lowest among all medical specialties.

"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," says the study's lead author, Dr. Tara F. Bishop, an assistant professor in the Department of Public Health and Medicine at Weill Cornell Medical College.

The number of psychiatrists is also quickly dwindling -- a drop of 14 percent from 2000 to 2008 -- because psychiatrists are retiring and medical students are not choosing to go into psychiatry. These issues may lead to a perfect storm of untreated mental health issues nationwide, Dr. Bishop says.

"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 the medical community," she says. "I must say we were surprised by the findings. 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."

These low insurance rates may "impact recent calls for increased access to mental health services, and if the trend of declining acceptance rates continues then the impact may be even more significant," the researchers say in their study.

"For example, not only are there fewer physicians who can help people with moderate to severe symptoms of mental illness, those patients must then try to find a doctor who will take their insurance," Dr. Bishop says. "This is not a formula for success."

Additionally, with the growth of the population, need for services will increase, she says. The Centers for Disease Control and Prevention estimates that a quarter of adults in the United States report having a mental illness at any given time, and that about half of adults will suffer from one in their lifetime.

While the term "mental illness" is broad, and includes depression and anxiety that general care doctors can help with, those doctors are overwhelmed, says Dr. Bishop, who is herself a primary care physician. "We don't have a work force that can keep up with all the issues -- mental health aside -- in our growing and aging population."

Solo practitioners less likely to accept insurance

The Weill Cornell investigators, working with researchers from Columbia University and the University of California, San Francisco, used a nationally representative survey to conduct their study. That database is the National Ambulatory Medical Care Survey (NAMCS), administered by the Centers for Disease Control's National Center for Health Statistics (NCHS). It represents about 90 percent of the ambulatory care delivered in the United States -- the care provided in private physician offices or group practices, Dr. Bishop says.

The database does not include psychiatric outpatient clinics linked to hospitals or large medical centers. "Some patients with some of the most severe mental illnesses, such as schizophrenia or bipolar disease, may be cared for in those clinics, and this database does not capture that population," she says.

The average number of physicians surveyed each year by the NAMCS is about 1,250, and psychiatrists represent 5.5 percent of these doctors.

The researchers don't know why psychiatrists are increasingly rejecting insurance payment; questions about motivation were not included in the survey. "But we can speculate that insurance provides lower reimbursement rates than psychiatrists feel cover the costs of care," Dr. Bishop says.

Part of the reason for this reluctance may be that it takes considerable time -- typically, an hour or so -- to provide counseling and therapy, and therefore, psychiatrists may not be able to see as many patients in a day as physicians of other specialties can, Dr. Bishop says.

Additionally, more psychiatrists than physicians of other specialties practice alone -- 60 percent -- and accepting insurance entails considerable administrative work, she says. The study found that these solo practitioners are less likely to accept all types of insurance.

These issues could be resolved if incentives are offered to medical students to pursue psychiatry, and if insurance payments to practicing psychiatrists are increased, the researchers say.

Dr. Bishop is delving deeper into the issues her study raises. She plans to interview psychiatrists to understand why they are not accepting insurance, and what can be done to change their minds.


Story Source:

The above story is based on materials provided by Weill Cornell Medical College. Note: Materials may be edited for content and length.


Journal Reference:

  1. Tara F. Bishop, Matthew J. Press, Salomeh Keyhani, Harold Alan Pincus. Acceptance of Insurance by Psychiatrists and the Implications for Access to Mental Health Care. JAMA Psychiatry, 2013; DOI: 10.1001/jamapsychiatry.2013.2862

Cite This Page:

Weill Cornell Medical College. "Half of psychiatrists reject private, federal insurance, preferring cash, study shows." ScienceDaily. ScienceDaily, 12 December 2013. <www.sciencedaily.com/releases/2013/12/131212100219.htm>.
Weill Cornell Medical College. (2013, December 12). Half of psychiatrists reject private, federal insurance, preferring cash, study shows. ScienceDaily. Retrieved November 29, 2014 from www.sciencedaily.com/releases/2013/12/131212100219.htm
Weill Cornell Medical College. "Half of psychiatrists reject private, federal insurance, preferring cash, study shows." ScienceDaily. www.sciencedaily.com/releases/2013/12/131212100219.htm (accessed November 29, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Saturday, November 29, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Rural India's Low-Cost Sanitary Pad Revolution

Rural India's Low-Cost Sanitary Pad Revolution

AFP (Nov. 28, 2014) — One man hopes his invention -– a machine that produces cheap sanitary pads –- will help empower Indian women. Duration: 01:51 Video provided by AFP
Powered by NewsLook.com
Research on Bats Could Help Develop Drugs Against Ebola

Research on Bats Could Help Develop Drugs Against Ebola

AFP (Nov. 28, 2014) — In Africa's only biosafety level 4 laboratory, scientists have been carrying out experiments on bats to understand how virus like Ebola are being transmitted, and how some of them resist to it. Duration: 01:18 Video provided by AFP
Powered by NewsLook.com
WHO Says Male Ebola Survivors Should Abstain From Sex

WHO Says Male Ebola Survivors Should Abstain From Sex

Newsy (Nov. 28, 2014) — WHO cites four studies that say Ebola can still be detected in semen up to 82 days after the onset of symptoms. Video provided by Newsy
Powered by NewsLook.com
Ebola Leaves Orphans Alone in Sierra Leone

Ebola Leaves Orphans Alone in Sierra Leone

AFP (Nov. 27, 2014) — The Ebola epidemic sweeping Sierra Leone is having a profound effect on the country's children, many of whom have been left without any family members to support them. Duration: 01:02 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins