- In-person and telehealth mental healthcare utilization increased during the COVID-19 pandemic, according to a study of insurance claims published on Friday in JAMA Health Forum.
- Spending on mental health services increased by 54%, and utilization soared by nearly 40% among commercially insured adults between January 2019 and August 2022.
- Whether the “disproportionate increase in spending” will remain is an open question, the authors note. Now that the public health emergency has ended, economists are eyeing insurers’ next move to determine whether they will continue or stop coverage for telehealth mental health visits.
The onset of the COVID-19 pandemic was associated with a rise of mental health disorders, particularly anxiety and depression, as decreased social engagement, threats to economic security and increased mortality drove distress.
The study released last week adds to a growing body of literature which suggests telehealth services reduced barriers to care for patients and helped providers meet increased demand for services.
Researchers from RAND reviewed 1,554,895 insurance claims for adults who receive health insurance through their employers and found telehealth was particularly important during the acute phase of the pandemic from March 2020 to December 2020, when telehealth utilization increased tenfold. In contrast, in-person visits dropped by 39.5%.
Though in-person mental healthcare visits returned to 80% of pre-pandemic levels by August 2022, many patients still choose to access care virtually, the study found.
Telehealth use remained at ten times pre-pandemic levels — a finding consistent with recent research suggesting patients’ preference for telehealth when seeking mental health care has continued into 2023.
Alongside increased utilization came increased spending. Pre-pandemic, mental healthcare ran insurers about $2.3 million per 10,000 beneficiaries per month; it increased to $3.5 million after the acute period of the pandemic.
“If this increased utilization affects spending, insurers may begin rejecting the new status quo,” RAND researchers wrote. “This concern is particularly relevant when considered against the backdrop of telehealth policies that expired alongside the national PHE declaration.”
Public health emergency policies that enabled widespread adoption of telehealth for mental healthcare are set to expire by 2024 unless federal lawmakers adopt policies that permanently enshrine flexibility and address key concerns, including payment parity, audio-only telehealth reimbursement and interstate licensures.
In June, a bipartisan group of lawmakers reintroduced the CONNECT for Health Act for a second time in Congress. The updated bill would remove geographic restrictions on telehealth services and the six-month in-person requirement for telemental healthcare.
Should the legislation or a similar policy not pass, researchers noted insurers may elect to stop coverage. However, researchers told the New York Times that if they do stop coverage, they may pay for that decision in other ways, such as when patients with unmet mental health needs require emergency department services.