Posted by Phillipa on December 18, 2013, at 21:03:03
Only one page of the article but they says most of it. Phillipa
Medscape Medical News > PsychiatryHalf of Psychiatrists Reject Health Insurance
Deborah Brauser
December 17, 2013
US psychiatrists have the lowest acceptance rate for all types of health insurance compared with physicians in other specialties, new research suggests.
Results from a national survey show that psychiatrists increasingly refuse to accept Medicare and Medicaid, or even private insurance. The survey revealed that in the 5 years between 2005 and 2010, the percentage of psychiatrists who accepted private insurance dropped by 17% to 55%, and those who accepted Medicare declined by almost 20% to 55%. At 43%, psychiatrists' acceptance of Medicaid is the lowest among all medical specialties.
Instead, psychiatrists were likely to charge cash for their services, said lead author Tara F. Bishop, MD, MPH, assistant professor in the Department of Public Health and Medicine at Weill Cornell Medical College in New York City.
"We were very surprised by our findings, but it validated some of the experiences I have had as a primary care doctor, as well as experiences by some of my coauthors," Dr. Bishop told Medscape Medical News.
She added that the study did not examine the reasons behind the insurance rejections. "But we can speculate that insurance provides lower reimbursement rates than psychiatrists feel cover the costs of care."
Commenting on the findings for Medscape Medical News, Jeffrey Lieberman, MD, president of the American Psychiatric Association (APA), agreed with Dr. Bishop's assertion.
"It's generally understood in healthcare currently that the so-called 'cognitive specialties' are reimbursed at a much lower, less financially desirable rate than the procedural and surgical specialties," said Dr. Lieberman to Medscape Medical News.
However, he noted that the recent issuance of the final rule on the Mental Health Parity and Addiction Equity Act may lead to future improvements, "if it's enforced adequately."
The study was published online in JAMA Psychiatry.
Shedding New Light
The investigators note that when it comes to insurance acceptance, little is known about the potential differences among medical specialties.
Dr. Tara Bishop
The researchers examined data from the National Ambulatory Medical Care Survey (NAMCS), which is administered by the Centers for Disease Control and Prevention's National Center for Health Statistics and represents approximately 90% of all ambulatory care delivered in the United States.
Dr. Bishop noted that the NAMCS does not include data on 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 said in a release.
The NAMCS surveys roughly 1250 physicians per year. It does not include data on the fields of pathology, radiology, or anesthesiology.
Results showed that between 2009 and 2010, 55.3% of psychiatrists vs 88.7% (P < .001) of other specialists accepted private noncapitated insurance. Similarly, 54.8% of psychiatrists vs 86.1% of other specialists (P < .001) accepted Medicare, and 43.1% vs 73% (P < .001) accepted Medicaid.
Cardiologists had the highest acceptance rate of private insurance (93.6%) and Medicare (99.4%).
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