Four in Five Psychologists Say Insurance Pay Isn't Worth the Bother

In 2024 the American Psychological Association asked psychologists why they'd left insurance networks, and 82% said the reimbursement rates simply weren't worth the admin. This includes practices like yours, if you've ever done that same sum on the back of an envelope.

Page updated: 13 Aug 2026

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Therapy practices weighing up whether to stay in-network are increasingly deciding the maths doesn't add up, and building a client base without an insurer's help.

Original Research	A survey of US psychologists found most who'd left insurance panels did so because the payouts weren't worth the paperwork.
Source	https://www.blueprint.ai/blog/private-practice-costs
Overview	Blueprint, a practice management platform for therapists, cites the American Psychological Association's 2024 Practitioner Pulse Survey on why psychologists drop insurance panels.
Year	2024
Publisher	Industry body, American Psychological Association (relayed via Blueprint)
Relevance to Wellbeing	Directly relevant to therapy practices, though the underlying insurance-panel dynamics are American and don't have a neat UK equivalent.
Our Verdict	Too early to tell The number itself checks out, but it's an American insurance story wearing a UK-relevant costume.
Our Summary	It confirms what most therapists already suspected, insurers don't pay enough to justify the network membership. It's a US-only survey about US-only insurance panels, so the figures won't survive the crossing to the UK. A large professional body did the asking, not a marketing department with a point to prove. Blueprint didn't run the survey themselves, they're repeating the APA's homework, so check the original if it matters to you.
Our Geo View	US-specific: relates to American insurance reimbursement panels, which don't map directly onto UK structures like the NHS or private health insurance.

Abstract of wellbeing niches and revenue flow

Recognise how this might impact your practice

Why this might matter to you

Coaching: This matters because coaches never had insurers to blame or rely on in the first place, so this marketing lesson arrived for them years ago.
Therapy: This matters because it's their story exactly, walking away from insurance panels means direct client marketing stops being optional and becomes the whole job.
Training: This matters because trainers watching therapists go private-pay are seeing what happens when an entire profession has to learn client acquisition overnight.
Alternative Healing: This matters because healers already operate outside the insurance system, so this is a preview of homework their therapist neighbours are only just starting.
Clinical: This matters because clinical practices weighing up their own network status now have a real number to point to when explaining why so many peers have left.
Retreat/Centre: This matters because centres hosting therapists in-house should expect more of them to arrive already thinking like small businesses, not just clinicians.

Where this came from

Blueprint, a practice management platform built for therapists, rounded up cost data showing that most psychologists who leave insurance panels do it over pay, not principle.

Blueprint blog, published 2024, citing the American Psychological Association's Practitioner Pulse Survey.

Credibility flags: original survey methodology and sample size not disclosed in Blueprint's summary; the APA is a large, established professional body, but this counts as a secondary citation rather than the primary report.

How we scored this

A relevance score out of 100, built from three things: how well it fits the six practice types, how recent it is, and how solid the methodology behind it is.

69%

Practice fit, 100How new, 70How solid, 25

Marked down on how solid the method is, since this is a secondary citation rather than the original report; practice fit stays high because it concerns therapists directly, and recency holds up fine, this is still last year's figures.

It's worth considering changes to your marketing practices

What this means for your marketing

Put your fee structure on your website before someone asks why you don't take insurance.
Say plainly that you're private-pay, and say why, before a prospective client assumes you're hiding something.
Brief your team on the reimbursement story, so nobody's caught flat-footed when a client raises it.
Build a referral ask into every client's final session, since no insurer is going to send you the next one.
Stop apologising for your rates in your copy. The APA has just told everyone insurers won't pay them either.

Who this is most useful for

Practice type	Relevance	Recommended action
Coaching	Low	Leave this one alone, it isn't your fight, focus your marketing elsewhere.
Therapy	High	Use this to justify open private-pay positioning in your marketing.
Training	Medium	Watch for therapist clients trained under insurance models who now need direct marketing help.
Alternative Healing	Low	Borrow the confidence, not the statistic, you were never insurance-bound anyway.
Clinical Practices	High	Review your own network status and message clients accordingly.
Retreats/Centres	Medium	Prepare in-house therapists for private-pay conversations with clients and guests.

Best before

Best before: worth revisiting once the APA runs its next Practitioner Pulse Survey, or before quoting this outside the US at all. Check current figures at Blueprint.

Well. Here We Are At The Bottom.

The best practitioners always find their way here. We have a story garden, a listening wind and a visual river waiting to make sense of themselves - they do, beautifully, in a twenty-five-minute conversation over a good coffee. How do you take it?

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