Despite a flattening of reimbursement rates and other concerns about mental health care in Medicare, not only is the feared and/or believed flight of mental health clinicians from Medicare not occurring, but the the actual trend is clearly in the opposite direction. The number of mental health clinicians opting out of Medicare has reached its peak, and is now decreasing.

As of this writing, a total of 8,661 psychiatrists, psychologists, and clinical social workers have opted out.

Overall, it is estimated that fewer than 2% of available mental health clinicians have opted out of Medicare. Psychiatrists have opted out most (about 13%), with fewer than 3% of psychologists opting out, and only about .6% of social workers opting out.

Sources used to estimate the number of licensed clinicians in these disciplines are here for social workers, here for clinical psychologists, and here for psychiatrists.

The number opting out peaked in 2016, and decreased in the two years since then.

The trend is the same across these three mental health disciplines, which together provide almost 98% of the psychotherapy received by Medicare beneficiaries.

Data source: Data.CMS.gov

It is worth asking, even in the context of flat rates and other perceived and actual risks, why is it that any loss of mental health clinicians in Medicare seems to have been stemmed? Could this be reproduced in other systems of care? Speculations and comments are welcome! In the mean time, Medicare beneficiaries ought to take heart. You’re able to have considerable freedom of choice to see a local mental health specialist for about an $18 co-insurance payment for almost an hour of therapy (less if you have a secondary insurance)!