- While the number of telemental health visits has grown in recent years, use is still low and varies widely across states, a new study in Health Affairs concludes.
- The researchers looked at Medicare fee-for-service claims data on telemental health use between 2004 and 2014 in rural beneficiaries with a diagnosis of any mental illness and found that the number of virtual visits grew on average 45.1% annually.
- However, usage varied widely across states — from 25 telemental health visits per 100 beneficiaries in nine states to none in four states and the District of Columbia.
Mental health is a big-ticket problem in the U.S. In any given year, about 25% of the population has a diagnosable disorder, two-thirds of which goes untreated, according to the Substance Abuse and Mental Health Administration. With 30% of Medicare payments currently tied to alternative payment models and the HHS calling for 50% by the end of 2018, telemedicine has been seen as a way to increase access and quality of care while reducing costs.
Last month, the American Telemedicine Association issued new practice guidelines on how to provide mental and behavioral health services to children and adolescents using real-time videoconferencing. The American Medical Association has also adopted ethical guidance to inform how doctors interact with patients in a virtual setting.
How best to boost telemental health use remains unclear. One option might be targeted expansion in urban healthcare settings where access to specialty mental health services is poor.
There has been a concern among doctors that telemedicine providers would talk away revenue from those providing in-office consultations. However, the researchers suggested that telemental health was largely complementing and supplementing in-office visits, rather than being the primary source of mental healthcare. Less than 15% of rural beneficiaries received mental health services solely via telehealth.