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Virtual mental health services reign

Virtual mental health care remained a top use for remote care services, despite overall telehealth use slipping.
By admin
Jan 17, 2023, 3:31 PM

Telehealth is still more prevalent than ever, but the utilization of remote care services is sinking slightly as patients return to in-person visits, according to the latest data from FAIR Health’s national claims database.

Among commercially insured individuals, telehealth claims shrank by 3.7 percent in October of 2022, the most recent month for which data is available. Telehealth claims now comprise only 5.2 percent of all private insurance services. The database does not track traditional Medicare, Medicare Advantage, or Medicaid claims.

The declines were largest in the South (6.8 percent), the Midwest (4.9 percent), and the West (4.1 percent), but were offset by gains in the Northeast to the tune of 1.7 percent.

This is the first time in several months that the nation has started to reduce its telehealth use, the company said, and may reflect changing needs for patients.

COVID-19 is no longer a top reason for virtual visits, the data reveals, dropping to the bottom of the list in terms of diagnoses.  Other acute respiratory viruses, including flu and RSV, took its place as these diseases started to spread widely among pediatric and elderly populations.

What hasn’t changed is the popularity of telehealth services for mental and behavioral healthcare concerns.  While respiratory viruses comprised 4.1 percent of telehealth claims in October, more than 65 percent of visits were related to mental health issues. The CPT code for one-hour psychotherapy remained the top telehealth procedure code, both nationally and in every region.

Telehealth has been crucially important for meeting mental and behavioral healthcare needs throughout the pandemic, with providers and patients taking advantage of regulatory flexibilities in Medicare to get access to care in an incredibly resource-strapped environment.

The National Council for Mental Wellbeing reports that 77 percent of counties experienced a severe shortage of mental health professionals in 2017.  Meanwhile, the Health Resources & Services Administration (HRSA) projects a further 20 percent decrease in the supply of adult psychologists by 2030, despite demand increasing by 3 percent over its currently unmet levels of need.

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Virtual care has emerged as a promising solution for extending the reach of existing mental and behavioral healthcare professionals, particularly to people living in rural areas or underserved urban communities.

However, the regulatory changes that made telemental health possible for more patients during the pandemic aren’t necessarily permanent.

Lawmakers recently extended key flexibilities to the end of 2024, including removing certain geographic barriers, delaying in-person visit requirements, and allowing audio-only visits.  But Congress will need to further codify these changes – and stakeholders will need to ensure they extend to commercial and state Medicaid plans – in order to truly redefine the mental health landscape.

The industry will also need to address issues of disparities in telehealth access, which affect aging patients and traditionally underserved socioeconomic groups.  As with other care modalities, some patients experience barriers to participating in virtual care due to low technological literacy and low health literacy.  Many communities face additional barriers because of poor broadband internet availability in rural areas or lack of privacy to discuss sensitive matters in crowded or multi-generational homes.

Solving for these problems will take sustained, coordinated effort from many areas of the healthcare ecosystem. State-level stakeholders will need to collaborate with medical schools to attract and retain behavioral health professionals and incent providers to work in underserved areas, such as rural communities and inner-city areas. Career development support and loan repayment programs have thus far shown promise for bringing providers into high-needs areas.

Related story: Healthcare orgs should plan for sustainable telehealth adoption

Health systems and payers will also need to invest in integrated digital platforms to enable virtual care at scale, including patient-facing apps to manage mental health conditions, audio/video equipment to help patients connect with providers from home, and data analytics tools to identify rising behavioral and mental health risks in vulnerable populations.

Combined with lawmakers’ increased willingness to make the telehealth environment more viable for mental and behavioral healthcare, these initiatives have the potential to mitigate dire shortfalls in provider availability and continue to keep telemental health open as an important path toward more accessible treatment for patients in need.

Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry.  Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.  She can be reached at jennifer@inklesscreative.com.


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