A new study finds that many psychiatric doctors listed as accepting new Medicaid patients are actually unavailable or unwilling to schedule appointments for beneficiaries of the government program. (iStock)
Many people with developmental disabilities who rely on Medicaid require mental health care, but new research finds that even among doctors who accept Medicaid, getting an appointment is difficult.
According to a “secret shopper,” fewer than 1 in 5 doctors listed as receiving new Medicaid enrolled patients were available and willing to schedule an appointment. study recently published in the journal JAMA.
The researchers called randomly selected psychiatrists, nurse practitioners and physician assistants who worked in the psychiatric field and were listed in the provider directories of Medicaid managed care plans in New York City, Los Angeles, Chicago and Phoenix. They requested the first available appointment for a person with depression. If the doctor they asked about was not available, they asked about other providers.
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According to the study, appointments were offered in only 18% of cases. However, even when an appointment was available, the waiting time could be up to six months.
“We have long known that relatively few psychiatrists participate in the Medicaid program, compromising access to needed care,” said Dr. William Schpero, an assistant professor of population health sciences at Weill Cornell Medical College, who worked on the study. “This is compounded by the problem identified in our study: Even among psychiatrists who are listed as Medicaid participants, actual access to care appears to be quite low.”
The researchers found that availability of psychiatric care varied across the cities in the study. In New York, it was easiest to get an appointment, with 36 percent of offices offering an appointment and the average wait time being 28 days. In contrast, in Los Angeles, only 15 percent of doctors were available and the average wait time was 64 days.
Among the 263 physicians who were unavailable, 15% had inaccurate or non-working phone numbers and 35% failed to respond on two separate attempts.
The findings highlight the need for greater enforcement, the researchers said.
“Most states have outsourced the delivery of the Medicaid benefit to private health plans,” said Dr. Diksha Brahmbhatt, the study’s lead author who now works at Brigham and Women’s Hospital in Boston. “It’s up to states, with guidance and oversight from the federal government, to ensure that these plans build networks of mental health professionals who don’t just participate in Medicaid on paper but actually make appointments available to enrollees.”
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