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Study: Psychiatrists refusing to accept private insurance

Study: Psychiatrists refusing to accept private insurance

More and more of America’s psychiatrists are refusing private insurance from patients, instead preferring cash.

A new study published in the journal JAMA Psychiatry finds that psychiatrists are refusing to accept Medicare and Medicaid, and even private insurance, as payment.

Between 2005 and 2010, investigators recorded a 17 percent drop in the number of psychiatrists who accepted private insurance.

Dr. Tara Bishop, assistant professor in the Department of Public health at Weill Cornell Medical College and lead author of the study, said as a primary care physician in the New York City area, she has personally had problems finding psychiatrists who would take anything but out-of-pocket payment.

tara bishop
Dr. Tara F. Bishop, MD, Weill Cornell Medical College

“This kind of confirmed what we have been thinking was going on but had never quantified in the past,” she said.

While researchers didn’t ask psychiatrists why they were refusing private insurance, Dr. Bishop says they are likely doing so for two reasons: They’re not getting enough reimbursement money from insurance companies, and many psychiatrists run a small-scale operation and simply cannot handle the paperwork that comes with insurance.

She says the solution lies in increasing insurance payments to practicing psychiatrists, and giving more incentives to medical students to pursue psychiatry.

The study’s findings were surprising for another reason, even to researchers—they found a drop of 14 percent in the number of psychiatrists from the year 2000 to 2008. Dr. Bishop says that’s because many medical students are not choosing to go into psychiatry.

“Like many fields in health care, there are some fields that are probably not as popular because of salaries and reimbursement. When you think about being a psychiatrist and providing psychiatric care I think someone has to really love doing that on a day-to-day-basis.”

She says she plans to interview more psychiatrists to understand why they are refusing insurance.

“We do hope in the future to do more of what we call qualitative data, or interviews with psychiatrists, to understand the reasons that this is a problem,” she said.

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