Finding the right level of care can depend on more than clinical need in eating disorder treatment. Location, insurance coverage, and the availability of specialized programs can all affect when options are realistically available.
A 2026 national study found that in-person eating disorder treatment is concentrated in metropolitan areas, with longer distances and lower accessibility in many rural communities. Higher-income and urban areas also had greater access to treatment. Telehealth expanded potential reach, but access remained uneven because of broadband availability and state-based practice boundaries (Liu et al., 2026).
Insurance can create another barrier. A separate 2026 study identified 384 intensive eating disorder treatment centers across 45 states and Washington, D.C. Only about one quarter of those centers accepted Medicaid, compared with more than 90% that accepted commercial insurance. Five states had no identified intensive eating disorder treatment centers in the study (Welch et al., 2026).
For providers, these findings raise a practical question: What happens when the appropriate referral is not readily available?
What providers can consider
Know the local treatment landscape. Familiarity with outpatient, intensive outpatient, partial hospitalization, residential, and inpatient options can make referrals more useful.
Ask about practical barriers. Transportation, insurance coverage, distance from treatment, work or school responsibilities, and reliable internet access may affect whether a referral is feasible.
Consider consultation when specialty care is limited. A patient may need support while waiting for an eating disorder specialist or traveling to a higher level of care. Consultation with an eating disorder professional can help inform next steps.
Continue building eating disorder knowledge. Providers do not need to become specialists to provide informed care. Primary care clinicians, pediatricians, behavioral health providers, sports medicine professionals, and others may recognize concerns and begin the referral process before specialty care is available.
Understanding those barriers can help providers make more realistic referrals and identify where additional support may be needed
Build your eating disorder knowledge
EDPEN offers in-person eating disorder trainings and customized virtual trainings for healthcare teams. Training can help providers recognize eating disorders, respond appropriately, and understand how to connect patients with specialized care.
Explore EDPEN training options for yourself or your team.
References
Liu, L., Huo, C., Beccia, A. L., Richmond, T. K., & Austin, S. B. (2026). Spatial and telehealth accessibility to eating disorder treatment in the United States: Evidence from registry and LLM-augmented data. International Journal of Health Geographics, 25(1), 44. https://doi.org/10.1186/s12942-026-00474-6
Welch, R., Rao, T., Karakus, M., Scott, E., Doreson, A., & Ghose, S. S. (2026). State-level analysis of access to intensive eating disorder care for Medicaid beneficiaries. Psychiatric Services, 77(3), 209–216. https://doi.org/10.1176/appi.ps.20250233