According to New Landland, four state policies put in place to facilitate the expansion of telemedicine during the COVID-19 pandemic were associated with the expansion of such services by mental health facilities, but black Facilities in counties with the highest percentage of residents had the lowest growth in telemedicine, he said. corporate research.
Telemedicine uptake was also lower in facilities hosting Medicaid or the Children’s Health Insurance Program, two government insurance programs that primarily help low-income Americans, according to the study.
The findings show that despite the rapid expansion of telemedicine during the pandemic, disparities in access to mental health care still existed.Research published in journals JAMA network open.
Our results suggest that national policies play an important role in expanding mental health access, but mental health access may be lost if telemedicine policies are not included in the plan. indicates that there is Similarly, disparities need to be addressed with local, targeted legislation. ”
Ryan McBain, lead author of the study and policy researcher at Rand University
RAND researchers sought to understand whether state-level policies were relevant to the expansion of telemedicine that occurred after the start of the COVID-19 pandemic.
The study focused on four policies: Equality of payments for face-to-face and telemedicine services among private insurers. Authorization for voice-only telemedicine services for those enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). Participate in interstate license exchange programs to enable psychiatrists to provide services across states. Participation in the Psychology Interjurisdictional Agreement will enable clinical psychologists to provide services across state lines.
To understand the impact of these policies on mental health facility telemedicine services, researchers analyzed information from more than 12,000 facilities collected by the Mental Health and Addiction Treatment Tracking Repository. They limited their focus to outpatient facilities, which play a large role in telemedicine.
The study, which examined the period from April 2019 to September 2022, found that the proportion of mental health treatment facilities offering telemedicine more than doubled during this period, from 39% to 88%. found.
During the study period, the number of states with pay parity laws increased from 6 to 28 states, and the number of states with voice-only payment policies increased from 0 to 33 states. The number of states allowing psychiatrists to practice across state lines has increased from 28 to 38. The number of places that allow clinical psychologists to practice across state lines increased from 7 to 32.
The researchers found that all four policies were significantly associated with mental health treatment facilities being more likely to offer telemedicine services.
Rural county mental health facilities were more likely to offer telemedicine than urban county facilities, and community mental health centers were more likely to offer telemedicine than other types of facilities.
The proportion of black residents in the county was associated with less likelihood that mental health facilities would offer telemedicine. Mental health facilities in counties with more than 20% black population were 42% less likely to offer telemedicine compared to counties with less than 5% black population.
The researchers also found that mental health facilities that accepted Medicaid and CHIP were about 25% less likely to offer telemedicine services. This is consistent with previous research findings that people enrolled in programs may have less access to outpatient care than those with private insurance.
“State policies appear to be rapidly increasing the availability of telemedicine in mental health facilities, but more efforts are needed to address disparities to ensure equal access to care for all groups.” said McBain.
Support for this research was provided by the National Institute of Mental Health.
Other authors of this study are Megan S. Schuler, Nabeel Qureshi, Samantha Matthews, Aaron Kofner, Joshua Breslau, and Jonathan H. Cantor.
RAND Health Care promotes healthier societies by improving healthcare systems in the United States and beyond.
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Reference magazine:
McBain, RK, other. (2023) Increased availability of telemedicine in mental health care after state-level policy changes from 2019 to 2022. Open JAMA network. doi.org/10.1001/jamanetworkopen.2023.18045.
