Demand is growing for mental health care in older adults, but Medicare Advantage (MA) networks lack enough psychiatrists to help, a new study found.
A report in Health Affairs shows that almost two-thirds of networks for psychiatrists taking Medicare Advantage (MA) have less than 25% of psychiatrists in a given service area.
“This means that many people who have coverage through Medicare Advantage plans may not actually have access to psychiatrists, given how few are considered in-network,” Jane Zhu, MD, assistant professor of medicine in the School of Medicine at Oregon Health & Science University, said in a statement.
About 28 million Americans use MA, which provides private insurance plans backed by Medicare. MA has a smaller network of psychiatrists available than people who use Medicaid managed care or by Affordable Care Act plans.
Zhu said the reality is that the networks don’t offer a lot of options. Also, even though psychiatrists are available, there’s a shortage of them. Many of the practitioners in-network may be fully booked and can’t accept new patients. Some people may give up on care, pay more in out-of-pocket costs, or have to postpone getting help.
“We know the actual number of psychiatrists available to see patients is much lower,” Zhu added.
In some areas, there was no psychiatrist accepting people with MA. This was the case in more than half of the counties they had data on.
Insurers must work to get more psychiatrists and mental health professionals to accept health insurance. Or they need to expand their coverage to include other professionals who can support mental health like psychologists, therapists, and primary care doctors, Zhu added.
