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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
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%).
Posted by alexandra_k on December 19, 2013, at 0:40:32
In reply to 1/2 Of Psychiatrists Reject Medical Insurances, posted by Phillipa on December 18, 2013, at 21:03:03
I wonder how neurology compares.
Posted by stargazer2 on December 19, 2013, at 10:12:19
In reply to Re: 1/2 Of Psychiatrists Reject Medical Insurances, posted by alexandra_k on December 19, 2013, at 0:40:32
Neurology is medically based so I would assume the payment for those diagnoses would be much higher than for psychiatrists.
My psychiatrist bills for 2 services so gets paid a decent amount else he would not make anywhere near what he could make with one code.
Posted by bleauberry on December 19, 2013, at 12:11:07
In reply to 1/2 Of Psychiatrists Reject Medical Insurances, posted by Phillipa on December 18, 2013, at 21:03:03
Better get used to it.
As early as 2014 we are going to see this happen, to a much greater degree than this article, in every single medical field, not just the mood departments.
Unless you will have cash, it is a 50/50 gamble at this time whether you will ever see one of your own chosen doctors again, your own chosen hospital again, or even your own desired medication. Administrative pinhead suits in Washington are going to decide all that for you.
And they are so generous as to do all that for you for just twice what you paid before.
Posted by Phillipa on December 19, 2013, at 18:38:31
In reply to Re: 1/2 Of Psychiatrists Reject Medical Insurances, posted by bleauberry on December 19, 2013, at 12:11:07
Not effecting my medicaire which I have earned for living long enough to collect it. I also chose to pay for supplemental insurance that allows me to pick the docs of my choice and the ability to refer myself to any sub specialty I chose. I've checked with all my docs and all is cool. As long as a doc accepts medicaire they will accept also your supplemental. Which means definitely don't pick one that is like an HMO. You pay more for what I have but well worth it. Phillipa
Posted by stargazer2 on December 19, 2013, at 20:17:18
In reply to Re: 1/2 Of Psychiatrists Reject Medical Insurances » bleauberry, posted by Phillipa on December 19, 2013, at 18:38:31
Phillipa,
I'm sure the pinheads don't care that you lived long enough to deserve it. They just care that
cuts are made so that they can reduce the deficit that they caused for their own agenda. Medicare and supplemental plans could be on the chopping block so whether you think you are safe now doesn't mean it will stay this way. All those pinheads have the best medical care so what "we" get is somethng they don't have to worry about getting themselves.How can we change the care that they get so that it is the same that they mandate everyone else gets? That is totally unfair but I'm sure they won't see it that way.
Posted by Phillipa on December 19, 2013, at 20:37:56
In reply to Re: 1/2 Of Psychiatrists Reject Medical Insurances, posted by stargazer2 on December 19, 2013, at 20:17:18
Oh I agree but for right now okay. And yes congress and other officials if their plan is so good should also have it. And why do they get salaries after they are no longer in office? I tell everyone if there is anything you think you need done get it done now. Phillipa
Posted by Phil on December 20, 2013, at 12:57:37
In reply to Re: 1/2 Of Psychiatrists Reject Medical Insurances » stargazer2, posted by Phillipa on December 19, 2013, at 20:37:56
if I got supplemental insurance I would be broke.
Posted by Phillipa on December 20, 2013, at 21:11:43
In reply to Re: 1/2 Of Psychiatrists Reject Medical Insurances, posted by Phil on December 20, 2013, at 12:57:37
Phil since you are solely responsible for bills and other you could be. I do have a home and no charges for other things. So I have the supplemental as need to know that no one can take my home away. Phillipa
Posted by Phil on December 23, 2013, at 9:02:41
In reply to Re: 1/2 Of Psychiatrists Reject Medical Insurances » Phil, posted by Phillipa on December 20, 2013, at 21:11:43
Yes and things are getting scary. But like my therapist said, if it's $900 tell them you can send $10 a month. As long as they show cash coming in what can they say.
Money problems like when I lost my house in the 80s are the worst stressers I can have. I'm going to die poor. Honestly I don't want to live past 70 anyway. I'm 60 and had the choice I'd go now. Natural death not suicide.
On the other hand I still take my pills so that says something.
I've always left the party early, It keeps people talking. Not trying to be gruesome, I've thought this way for a long time.
As far as suicide goes, elderly white males lead the pack.
This post doesn't have much holiday spirit.
Posted by alexandra_k on December 23, 2013, at 13:56:19
In reply to Re: 1/2 Of Psychiatrists Reject Medical Insurances, posted by stargazer2 on December 19, 2013, at 10:12:19
> Neurology is medically based so I would assume the payment for those diagnoses would be much higher than for psychiatrists.
psychiatry is also considered medically based. that is why DSM dx's (e.g., autistic spectrum) will sometimes get you more mileage from health insurers etc than disorders that aren't included in the DSM (e.g., avoidant attachment). If that is a concern...
Neurology is sometimes considered a 'cognitive' speciality, too. Which is why I wondered...
Epilepsy...
Sleep disorders...Etc.
Posted by Phillipa on December 23, 2013, at 19:56:06
In reply to Re: 1/2 Of Psychiatrists Reject Medical Insurances » Phillipa, posted by Phil on December 23, 2013, at 9:02:41
Phil I've heard the same. But I wonder what happens as the money accumulates if you keep seeing the docs? Like a credit card when only interest is paid? I want to live forever. I just want me back. Phillipa
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