MedCentralAfter Medicare Enrollment, Adults Drop Mental Health Visits

New research published in Health Affairs reveals a significant disparity in healthcare utilization patterns among Medicare enrollees at age 65. Although Medicare enrollment resulted in increased visits across most healthcare provider types, mental health visits showed a slight decline. The study, analyzing data from more than 13,000 individuals across 179,000 person-months, highlights critical challenges in mental healthcare access for older adults.

Key Points:

• Medicare enrollment at age 65 triggered a substantial increase in Medicare coverage from 16% to 96%, coupled with a decrease in private insurance from 71% to 48%, with 30% of beneficiaries choosing Medicare Advantage plans
• Healthcare utilization data showed a 14.4% increase in primary care visits and a 30.5% increase in visits to other provider types, while mental health provider visits decreased (though not statistically significant)
• Mental health practitioners frequently opt out of Medicare due to low reimbursement rates, strict documentation requirements, and concerns about audits and clawbacks
• A significant geriatric mental health workforce shortage exists, with insufficient psychiatrists and psychologists specifically trained in geriatrics to meet growing demographic demands
• The research suggests that collaborative care models, expanded telemental health services, and enhanced primary care-mental health partnerships could improve mental healthcare access for Medicare beneficiaries

Only about 50 of the 1,500 physicians who graduate from psychiatry residency programs each year pursue additional training in geriatric psychiatry and fewer than half of the available positions in geriatric psychiatry training programs are filled each year. (Archstone Foundation)

Medicare Summaries