Effect of Medicare Enrollment on Mental Health Care Utilization for Low-Income Patients

Enrolling in Medicare at age 65 may reduce mental health care utilization for individuals with mental health symptoms and low incomes, according to a study published in Health Services Research.

Researchers utilized a fuzzy regression discontinuity design to compare outpatient mental health visits and psychotropic drug fills in individuals younger and older than the age 65 Medicare eligibility threshold. Data were analyzed from the 2014-2021 Medical Expenditure Panel Survey, focusing on individuals with probable mental health symptoms based on Kessler K6 and PHQ-2 scores and incomes less than 400% of the federal poverty level. 

Enrolling in Medicare was linked to a lower likelihood of outpatient mental health visits and psychotropic drug fills among those with mental health symptoms and lower incomes. There was no significant difference in the effects of Medicare Advantage and Traditional Medicare on mental health care utilization. Medicare enrollment also did not appear to impact visits to primary care providers, nonmental health care specialists, or fills for non-psychotropic drugs.

“Enrolling in Medicare is associated with a reduction in the use of mental healthcare among individuals with probable mental health symptoms and low or moderate family incomes. Our findings suggest that the program poses access barriers specific to mental healthcare,” researchers said. 

Reference
McCormack G, Duffy E, Rohrer J, Biener A. Enrollment in Medicare is associated with fewer outpatient mental healthcare visits among those with mental health symptoms. Health Serv Res. Published online December 30, 2024. doi:10.1111/1475-6773.14423