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Abstract

Objective:

The authors aimed to analyze psychiatrists’ and other physicians’ acceptance of insurance and the associations between insurance acceptance and specific physician- and practice-level characteristics.

Methods:

Using the restricted version of the National Ambulatory Medical Care Survey, January 2007–December 2016, the authors analyzed acceptance of private insurance, public insurance, and any insurance among psychiatrists compared with nonpsychiatrist physicians. Because data were considered restricted, all analyses were conducted at federal Research Data Center facilities.

Results:

The unweighted sample included an average of 4,725 physicians per 2-year time grouping between 2007 and 2016, with an average of 7% being psychiatrists. Nonpsychiatrists participated in all insurance networks at higher rates than did psychiatrists, and the acceptance gap was wider for public (Medicare and Medicaid) than private (noncapitated and capitated) insurance. Among psychiatrists, those practicing in metropolitan statistical areas and those in solo practices were significantly less likely than their peers in other locations and treatment settings to accept private, public, or any insurance. These findings were also observed among nonpsychiatrists, although to a lesser extent.

Conclusions:

In addition to general policy interventions to improve insurance network adequacy for psychiatric care, additional measures or incentives to promote insurance network participation should be considered for psychiatrists in solo practices and those in metropolitan areas.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 25 - 31
PubMed: 37424301

History

Received: 23 November 2021
Revision received: 1 October 2022
Revision received: 13 February 2023
Accepted: 19 April 2023
Published online: 10 July 2023
Published in print: January 01, 2024

Keywords

  1. Insurance
  2. Outpatient treatment
  3. Public policy issues
  4. Community mental health services
  5. Mental health systems

Authors

Details

Andrew D. Carlo, M.D., M.P.H. [email protected]
Meadows Mental Health Policy Institute, Dallas (Carlo); Department of Psychiatry and Behavioral Sciences (Carlo, Jordan) and Center for Health Services and Outcomes Research, Institute for Public Health and Medicine (Jordan), Northwestern University Feinberg School of Medicine, Chicago; Departments of Pharmacy, Health Services, and Economics (Basu) and Department of Psychiatry and Behavioral Sciences (Unützer), University of Washington, Seattle.
Anirban Basu, Ph.D., M.S.
Meadows Mental Health Policy Institute, Dallas (Carlo); Department of Psychiatry and Behavioral Sciences (Carlo, Jordan) and Center for Health Services and Outcomes Research, Institute for Public Health and Medicine (Jordan), Northwestern University Feinberg School of Medicine, Chicago; Departments of Pharmacy, Health Services, and Economics (Basu) and Department of Psychiatry and Behavioral Sciences (Unützer), University of Washington, Seattle.
Jürgen Unützer, M.D., M.P.H.
Meadows Mental Health Policy Institute, Dallas (Carlo); Department of Psychiatry and Behavioral Sciences (Carlo, Jordan) and Center for Health Services and Outcomes Research, Institute for Public Health and Medicine (Jordan), Northwestern University Feinberg School of Medicine, Chicago; Departments of Pharmacy, Health Services, and Economics (Basu) and Department of Psychiatry and Behavioral Sciences (Unützer), University of Washington, Seattle.
Neil Jordan, Ph.D.
Meadows Mental Health Policy Institute, Dallas (Carlo); Department of Psychiatry and Behavioral Sciences (Carlo, Jordan) and Center for Health Services and Outcomes Research, Institute for Public Health and Medicine (Jordan), Northwestern University Feinberg School of Medicine, Chicago; Departments of Pharmacy, Health Services, and Economics (Basu) and Department of Psychiatry and Behavioral Sciences (Unützer), University of Washington, Seattle.

Notes

Send correspondence to Dr. Carlo ([email protected]).
This research was presented in part at a virtual session of the American Psychiatric Association Annual Meeting, May 1–3, 2021.

Competing Interests

Dr. Carlo reports working as a consultant for Otsuka. Dr. Basu reports working as a consultant with Salutis Consulting. The other authors report no financial relationships with commercial interests.

Funding Information

This study was supported by NIMH (award 6T32 MH-073553-15 to Dr. Carlo). Funding for the restricted data used in this investigation was provided through the National Center for Health Statistics (NCHS)/Academy Health National Health Policy Fellowship Program. The authors thank the NCHS, Research Data Center, United States Census Bureau, and Academy Health for their support with this project.

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