A cohort study published in JAMA, a monthly open access medical journal published by the American Medical Association, examined the impact of four state policies on teleheath availability in 12,828 mental health treatment facilities during the COVID-19 pandemic. The study found that 88.1% of facilities offered telehealth services, a massive increase from April 2019.
The report, published on June 13, analyzed policies including payment parity, reimbursement for audio-only telehealth services, participation in interstate licensure compacts and participation in the PSYPACT. The study found that the policies were associated with increased odds of telehealth availability, and by September of last year 88.1% of facilities offered the services. This was a major increase in comparison to 39.4% in April 2019.
Ryan McBain of the Rand Corporation also conducted a study and weighed in on the findings.
"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,” said McBain, who is a policy researcher and lead author of the RAND study.
McBain discussed the need for more efforts to address access disparities and also ensure equal access to mental health car. State policies have played a major role in the expansion of telehealth availability in mental health facilities, but more work is need to prpvide equitable access. The study showed the importance of sustaining telehealtjh policies.
The JAMA report noted that among the facilities studied, 88.2% accepted Medicaid and 26.3% operated as Community Mental Health Centers (CMCH). Most of the facilities were in urban areas that had a lower proportion of Black and Hispanic residents. It was reported that the amount of states with payment parity policies and audio-only telehealth visits dropped significantly. And all four state policies examined were associated with higher odds of offering telehealth. Telehealth availability was influenced by a variety of factors such as accepting Medicaid, being a CMCH, a rural location and county demographics. Percentage of Hispanic residents or internet access did not show an impact, the study found.
The JAMA study also found that disparities in access continue despite progress in telehealth expansion. The counties with a higher amount of Black residents and facilities accepting Medicaid and Children’s Health Insurance Program were less likely to offer telehealth services. However, facilities in rural counties were more likely to have telehealth services.
