Nearly half of behavioral health providers that accept Medicare and Medicaid patients have no availability for new patients, a report from HHS’ Office of Inspector General found.
The report, published June 26, is part of a three-report series examining access to behavioral healthcare for those with public insurance. A report published in April 2024 found relatively few behavioral providers accept Medicaid, Medicare or Medicare Advantage.
Here are five findings to note:
- Of the providers surveyed, 45% were unable to accept new traditional Medicare, Medicare Advantage or Medicaid patients.
- Nearly three in four, or 73% of, providers who were unable to accept new publicly insured patients said they did not have the capacity to accept any new patients, regardless of their insurance.
- The remaining one in four providers with full caseloads said they had stopped accepting Medicaid, Medicare and Medicare Advantage patients.
- New patient availability was similarly limited in urban and rural areas, and among both providers who can and cannot prescribe medication.
- Among providers who were able to accept new Medicare or Medicaid patients, around one in four had wait times longer than 30 days.
The findings “reiterate the importance of OIG’s previous recommendations that were made in the first report of this series” in 2024, the report stated. The OIG recommends that CMS takes step to encourage more behavioral health providers to join Medicaid and Medicare networks. The agency has also urged CMS to use network adequacy standards to increase the number of behavioral health providers in Medicare Advantage and Medicaid managed care plans.
Read the full report here.
