The American Psychological Association’s 2024 Practitioner Pulse Survey reveals that despite the persistently high demand for mental health treatment, administrative and financial barriers are causing numerous psychologists to refrain from participating in insurance networks. These barriers imposed by many insurance companies are making it tougher for psychologists to stay in-network and, consequently, for patients to obtain the care they desperately need, thereby worsening the ongoing mental health crisis.
This annual survey, which was carried out among 853 psychologists in September 2024 by the APA and its companion organization APA Services Inc, uncovered some concerning figures. Around one-third (34%) of psychologists were not accepting any form of health insurance, and nearly half of these (48%) had previously participated in insurance networks. Only 18% of psychologists stated that they had never been part of an insurance network throughout their careers.
Among the psychologists who either quit insurance networks or never joined them in the first place, over 8 in 10 (82%) identified insufficient reimbursement rates as the primary obstacle to taking insurance. Moreover, 62% reported facing administrative challenges, such as pre-authorization requirements and audits, which stood in the way of their participation. Additionally, more than half of this group (52%) pointed to concerns regarding payment reliability, including payment delays and refund demands, as significant barriers.
Arthur C. Evans Jr., PhD. , the APA Chief Executive Officer, said, “We’ve heard from individual psychologists who have been pressured by insurance companies to cut off care to patients, including those with serious mental illness or at risk for suicide. Psychologists have spent countless hours tracking down missed payments and lost thousands of dollars in audits that may take place months or years after service is provided. These insurance hurdles are not only hurting psychologists—they are hurting the patients who need care the most.”
These findings coincide with indications that the demand for mental health treatment continues to skyrocket. More than half (53%) of psychologists reported having no openings for new patients. A similar number (51%) noted an increase in symptom severity among patients, and over four in 10 (44%) stated that their patients have required an increased duration of treatment.
Lynn Bufka PhD, APA’s head of practice, commented, “Psychologists want to work with insurance providers to provide access to patients who must rely on their insurance for their mental health needs. But when a company’s reimbursement rates are too low and the administrative burdens are too high, some psychologists have had to make difficult choices about whether to work with those insurers. Those insurance companies could fix this problem and increase access to mental health treatment for patients by simply paying psychologists fairly and reducing the unnecessary administrative burdens that hinder their ability to provide care.”
The APA Practitioner Pulse Survey series has been conducted annually since 2024. Initially designed to track changes in psychological practice during the COVID-19 public health emergency, the survey has since been revised to monitor workforce changes after the emergency ended in May 2023.
The survey was conducted online and distributed via email. It employed a probability-based random sample, ensuring that all potential survey invitees had an equal chance of being selected. Invitations were sent to a sample of 35,000 on Sept. 4, 2024, and several reminder emails were dispatched to encourage completion. The survey concluded on Sept. 30, with a completion rate of 3.1%.
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