The percentage of tele-mental health venues more than doubled between 2019 and 2022.
State policies adopted during the COVID-19 public health emergency more than doubled the number of mental health providers offering tele-mental health services.
However, expanded access to virtual care was lower in counties with a greater percentage of Black residents, according to a RAND Corporation study released Tuesday.
"Our results show that state policies have an important role to play in expanding access to mental health, which could be lost if telehealth policies don’t stay on the books," says Ryan McBain, lead author of the study and a policy researcher at RAND. "Likewise, disparities need to be addressed with local, targeted legislation."
The study examined four pandemic-related state policies: payment parity for telehealth services among private payers; authorization of audio-only telehealth services for Medicaid and the Children’s Health Insurance Program (CHIP); and participation in the Interstate License Exchange Program and the Psychology Interjurisdictional Compact, permitting psychiatrists and clinical psychologists, respectively, to work across state lines.
Using data from more than 12,000 mental health providers that was collected by the Mental Health and Addiction Treatment Tracking Repository about more than 12,000 facilities, the study focused on outpatient venues, which play an outsized role in telehealth care.
Between April 2019 and September 2022, the percentage of mental health treatment venues offering telehealth more than doubled, from 39% to 88%, the study found.
The number of states adopting payment parity during the 42-month study period grew from six to 28 and the number of states with audio-only payment policies increased from zero to 33. States allowing psychiatrists to practice across state lines grew from 28 to 38, while those allowing clinical psychologists to practice across state lines rose from seven to 32.
In addition, mental health providers in rural counties were more likely to offer telehealth than their urban counterparts, while Community Mental Health Centers were more likely to offer telehealth than other types of facilities.
However, when compared with counties with 5% or fewer Black residents, mental health facilities in counties with more than 20% Black residents were 42% less likely to offer telehealth.
Researchers also found that mental health facilities that accepted Medicaid and CHIP were about 25% less likely to offer telehealth services.
"This is consistent with previous studies finding that people enrolled in the programs may have reduced access to outpatient care as compared to people who have private insurance," the study notes.
“Our results show that state policies have an important role to play in expanding access to mental health, which could be lost if telehealth policies don't stay on the books. Likewise, disparities need to be addressed with local, targeted legislation.”
Ryan McBain, RAND Corp.
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.
KEY TAKEAWAYS
The number of states adopting payment parity grew from six to 28, and the number of states with audio-only payment policies increased from zero to 33.
States allowing psychiatrists to practice across state lines grew from 28 to 38, while those allowing clinical psychologists to practice across state lines rose from seven to 32.
Mental health providers in rural counties were more likely to offer telehealth, while Community Mental Health Centers were more likely to offer telehealth than other types of facilities.
When compared with counties with 5% or fewer Black residents, mental health facilities in counties with more than 20% Black residents were 42% less likely to offer telehealth.
Researchers also found that mental health facilities that accepted Medicaid and CHIP were about 25% less likely to offer telehealth services.