New data from the federal government found that only a slim majority of behavioral health providers are able to take on new patients covered by Medicare or Medicaid in a timely manner. The data also revealed that telehealth is not an extender of providers’ availability.

The latest in a series of reports by the U.S. Department of Health and Human Services’ (HHS) Office of the Inspector General (OIG), the report assessed the availability of behavioral health services for patients covered by Traditional Medicare, Medicare Advantage, Medicaid managed care for adults and Medicaid managed care for children.

Overall, 45% of all providers surveyed reported being unable to take on new patients covered by these programs. Of those that said they could take on new patients, nearly one-quarter had wait times of more than 30 days.

However, 48% of providers that reported being able to take new patients said they had wait times of seven days or less. There were notable differences among the program types for both overall availability and length of wait times.

“Many providers reported that their caseloads were too full to accept new patients, although some providers confirmed that they still treated existing patients enrolled in Medicare or Medicaid,” the report explained. “For example, one Medicare Advantage provider said they might take a new patient in an urgent situation but did not have room in their schedule for regular treatment.”

Between the two programs, there was generally more availability and shorter wait times for those covered by Medicaid: 43% of providers were not available to take on patients with Traditional Medicare, 53% could not take on Medicare Advantage patients, 44% couldn’t take on adults with Medicaid while 42% couldn’t take on children with Medicaid.

To some degree, there may have been a slight reduction in behavioral health providers that contract with these types of health plans.

“About one-quarter of providers who could not make new-patient appointments reported that they were no longer taking new Medicare or Medicaid enrollees, often reporting that they had stopped participating in traditional Medicare, Medicare Advantage, or Medicaid managed care,” the report continued.

The report was light on details about these providers. One example provided by the report is one unnamed provider having difficulty getting paid by an unspecified Medicare Advantage plan.

In terms of wait times, providers that treat those with Medicare Advantage and children with Medicaid were the most likely to have wait times that were 30 days or more, which the report characterized as “long wait times.” The former saw 36% of providers, while the latter had 32% of providers that have long wait times.

About 21% of providers accepting new patients with Traditional Medicare had wait times of 30 days or longer. That number was 11% for adults with Medicaid.

A little more than half of providers (53%) could see a new patient on either Medicaid or Medicare via telehealth or in-person for a first appointment. Most providers wanted to start the patient relationship with an in-person visit; 36% required it. Often, telehealth is held up as a potential solution to access challenges

“When asked about wait times, most of these providers reported the same date for a new patient appointment, whether in person or via telehealth,” the report noted.

The report didn’t offer new recommendations to HHS.

The OIG is something of an internal referee or watchdog for the department. Rather, it cited a previous report it released in 2024 about how to address access-to-care challenges for those on Medicare and Medicaid. 

“Such steps could include strategies for reducing administrative burden for providers and reviewing and ensuring the appropriateness of payment rates for behavioral health services,” stated the report. “An increase in providers could help increase access and could help reduce wait times, particularly for people enrolled in traditional Medicare.”