The proportion of psychiatrists billing traditional Medicare has dropped by nearly 17% since 2014.

New research published in JAMA found that the nationwide proportion of psychiatrists billing Medicare Part B declined from 44% in 2014 to 33% in 2022.

Despite the decline in psychiatrist billing for Medicare, the number of active psychiatrists increased by 12.1% during the years of the study. This trend is unique to behavioral health, according to researchers.

“In this study, there was a per-enrollee decline in Medicare Part B–accepting psychiatrists across every region across the US, despite a more than decade-long increase in the number of medical students entering training to become psychiatrists each year,” authors of the study wrote. “These findings of decreasing numbers of psychiatrists serving Medicare Part B enrollees despite increasing numbers of these active professionals have, to our knowledge, not been documented for any other medical specialty.”

Specifically, the number of psychiatrists billing Medicare Part B declined by 3,772 between 2014 and 2022. However, the number of active psychiatrists increased by 6,076 during the same period.

The large study consisted of more than 291 million Medicare Part B enrollees. Researchers found that the number of Medicare Part B enrollees decreased by 10.6% between 2014 and 2022.

While researchers found an overall decrease in the proportion of psychiatrists billing Medicare, geographic variations were significant. For example, in Alabama, there was an increase of 31.7% of providers serving traditional Medicare. Meanwhile, there was a 67.8% decrease in Wyoming. Despite these regional differences in service provision, all states and districts analyzed showed a reduction in the percentage of active psychiatrists who actually billed Medicare Part B for services.

“We further identified sizable regional and state-level variation in access to care, with the most underserved state having less than one-tenth the per-capita psychiatrists serving Medicare Part B of the most served state,” researchers said. “Taken together, the results of this study suggest a potential decline in access to psychiatrist-led care among many individuals with mental and physical disabilities and older adults nationwide. The causes of these findings and their implications on mental health care access and equity merit further research.”

The behavioral health needs of older adults are growing. More than 20% of adults over 60 have a mental health or neurological condition, according to the American Medical Association. Several provider organizations are now focusing on the senior Medicare population. For example, Talkspace has rolled out a new Medicare strategy, and Talkiatry launched a behavioral health program for seniors.