Monday, October 28, 2019

Use of Telepsychiatry Nearly Doubles From 2010 to 2017, Study Finds

Nearly twice as many mental health facilities in the United States offered telepsychiatry in 2017 than in 2010, according to a study published in Psychiatric Services. Telepsychiatry was most commonly offered by facilities in underserved and rural areas.

“Facilities with telepsychiatry offer a variety of services to a wide range of populations, and the increased use of these services among populations with greater barriers to access, such as those residing in rural and underserved areas, continues to [show] promise that such services will be made available to patients with the greatest need,” wrote Stanislav Spivak, M.D., of Johns Hopkins University School of Medicine and colleagues.

Spivak and colleagues analyzed national data from the Substance Abuse and Mental Health Services Administration’s National Mental Health Services Survey (NMHSS) collected between 2010 and 2017. The survey asked facilities that provide mental health treatment if they provided telepsychiatry—defined as “the ability for health care providers, working from a distance using telecommunications technology, to communicate with patients, diagnose conditions, provide treatment, and discuss health care issues with other providers to ensure quality health care services are provided.” The researchers compared the ownership, licensing, funding, and treatment setting of those facilities that reported offering telepsychiatry in 2017 with those that did not. They also asked state mental health agency officials whether telemedicine was reimbursed by state funds and/or Medicaid funds, and if the state had initiatives to expand the use of telemedicine.

In 2010, 15.2% (n=1,580) of the facilities surveyed reported using telepsychiatry; in 2017, that number grew to 29.2% (n=3,385) of the facilities surveyed. But the authors noted “considerable variability” among states, with less than 15% of facilities offering telepsychiatry in some states compared with over 60% in others. The increase in the proportion of facilities with telepsychiatry from 2010 to 2017 was highest in states with a rural population of 40% or more, the authors noted.

“Facilities that offered telepsychiatry had higher odds of being funded by federal and local government sources, as well as by private insurance, self-pay, and grant funding compared with facilities without telepsychiatry,” Spivak and colleagues wrote. In contrast, facilities offering telepsychiatry were less likely to be funded by Medicaid than those without telepsychiatry—a finding the authors described as “puzzling, as the federal Medicaid statute allows reimbursement of telemedicine as a regular service.” The lower odds of facilities using telepsychiatry receiving funding from Medicaid “may reflect the effect of state Medicaid regulatory hurdles,” they wrote.

State funding may also explain the variability in telepsychiatry from state to state. States that did not provide direct state funding for telemedicine had lower odds of offering telepsychiatry services (19.3% vs. 29.8%), the authors noted.

For related information, see the Psychiatric News article “Telepsychiatry: Who, What, Where, and How.”

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