Insurance Barriers, Provider Scarcity Limits Patient Access to Psychologists

The shortage of psychologists accepting insurance, combined with full caseloads and high demand, has made mental health care increasingly difficult to access.

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According to a new report by the American Psychological Association, roughly a third of psychologists do not accept insurance. Among those who accept insurance, private and commercial pay health plans were the most commonly accepted form of insurance.

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In fact, 58% of psychologists said they participate in private/commercial insurance, 36% participate in traditional fee-for-service Medicare and 26% report participating in Medicare Advantage. Meanwhile, only 16% participate in traditional fee-for-service Medicaid and 18% accept managed Medicaid.

Psychologists working in hospitals, medical schools or organized human service settings were more likely to accept insurance than their peers in private practice.

According to the survey, 82% of psychologists reported insufficient reimbursement rates were a barrier to being in-network with insurance plans. Administrative issues, concerns about payment reliability and the denial of coverage for a service the provider deemed necessary were other key barriers to reimbursement.

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But that’s not the only barrier for patients to access care. In addition to low in-network coverage, less than half of clinicians did not have openings for new patients. Overall, psychologists reported treating fewer patients and working fewer hours than in 2023. Authors of the report attribute this to more clinicians entering the later career stages and reducing their caseloads.

“Psychologists continue to face capacity issues such as longer waitlists, patients with increasingly severe symptoms, increases in treatment course length, and a sense that they are unable to meet the demand for treatment,” authors of the study said.

More than half of psychologists reported an increase in the severity of symptoms among their patients, and 43% reported an increase in the length of treatment courses among patients.

Burnout is still a main issue in the field. A third of psychologists reported feeling burned out. This trend was particularly prominent among early career clinicians with more than half reporting feeling burnt out. Still, the overall burnout rate has declined for the last four years.