Medicare Advantage Psychiatric Networks Limited Compared to Medicaid, Exchange Plans

Behavioral Health Business July 7, 2023
Chris Larson

Psychiatry networks in Medicare Advantage plans are more limited than in Medicaid or individual health exchange plans.

A study by researchers at Oregon Health & Science University (OHSU), Johns Hopkins University and the University of Pittsburgh found that 65% of Medicare Advantage plans had psychiatrist networks that were considered narrow or included fewer than 25% of a service area’s psychiatrists.

By comparison, 43% of Medicaid managed care plans and about 40% of exchange plans had narrow psychiatrist networks.

Regardless of plan type, psychiatrist networks were narrower than those of other provider types. Primary care physicians and specialists see the share of narrow networks limited to about 20% to 30%.

The study examined 682 Medicare Advantage networks, 167 Medicaid managed...

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