What is it about?
Medicare Advantage enrollment has grown substantially, raising concerns about access to mental health care. This analysis suggests that restrictive provider networks, high out-of-pocket costs, and prior authorization requirements may limit access, worsen inequities, and discourage psychiatrists from participating in Medicare. Further research is needed to understand the effects on care quality and patient outcomes and to identify ways to improve access, affordability, and equity.
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Why is it important?
This article examines how Medicare Advantage (MA) practices are reshaping mental health care by restricting access, increasing costs, and adding burdens for patients and providers. Amid recent large-scale insurer retractions from MA markets and health system withdrawals from MA plans, this timely article highlights MA enrollees’ vulnerability to market and policy shifts and the urgent need to understand how MA’s growing role affects access, affordability, equity, and continuity of mental health care.
Perspectives
As a psychiatrist who has worked in public and private settings, I have seen how Medicare Advantage practices, such as prior authorization and network restrictions, create barriers to patient care and contribute to moral injury among physicians. I hope this article provides readers with a thorough understanding of the profound differences between traditional Medicare and the popular Medicare Advantage program and how those differences affect persons seeking and providing psychiatric care.
Belinda McIntosh
Emory University
More than half of eligible Medicare beneficiaries are now enrolled in Medicare Advantage, making it increasingly important for psychiatrists to understand how these plans differ from traditional Medicare. Differences in provider networks, prior authorization requirements, and cost sharing have important implications for patients’ access to mental health care, affordability, and equity.
Robert Cotes
Emory University
Read the Original
This page is a summary of: The Rise of Medicare Advantage: Implications for Psychiatric Care, Psychiatric Services, October 2026, American Psychiatric Association,
DOI: 10.1176/appi.ps.20260050.
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