Friday, August 25, 2023

Mental Health Service Use, Spending Jumped During Pandemic, Remain Elevated

Spending on mental health services among Americans with private health insurance has surged since the beginning of the COVID-19 pandemic, a research letter published today in JAMA Health Forum has found. The results suggest that spending on mental health services is continuing to rise even as the use of telehealth has plateaued.

Jonathan H. Cantor, Ph.D., of the RAND Corporation and colleagues examined data from 1,554,895 mental health service claims to ascertain trends in mental health services use and spending during three periods:

  • Pre-pandemic, before the declaration of the public health emergency (January 1, 2019, to March 12, 2020).
  • Acute phase of the pandemic, before vaccines were available (March 13, 2020, to December 17, 2020).
  • Post-acute phase of the pandemic (December 18, 2020, to August 31, 2022).

The researchers found that during the acute phase, in-person visits decreased by 39.5% and telehealth visits increased roughly 1,019.3% (roughly tenfold) compared with the year prior. Jointly, this represented a 22.3% increase in overall service use. During the post-acute phase, telehealth visits stabilized at approximately 1,068.3% of pre-pandemic levels, whereas in-person visits increased 2.2% each month over the period. By August 2022, in-person visits reached 79.9% of pre-pandemic levels, and overall mental health service use was 38.8% higher than before the pandemic.

During the acute phase, per capita expenditures for mental health services were 29.5% higher compared with the year prior. During the post-acute phase, spending for telehealth services remained stable, and spending for in-person care decreased to pre-pandemic levels. However, the average spending rate on mental health services was $3,547,424 per 10,000 beneficiaries per month in the post-acute phase, compared with $2,308,247 during the pre-pandemic phase, a 53.7% increase.

“These findings suggest that telehealth utilization for mental health services remains persistent and elevated. If this increased utilization affects spending, insurers may begin rejecting the new status quo,” Cantor and colleagues wrote. “This concern is particularly relevant when considered against the backdrop of telehealth policies that expired alongside the national [public health emergency] declaration.”

For related information, see the Psychiatric News article “Expect a ‘Long Tail’ of Mental Health Effects From COVID-19.”

(Image: iStock/BlackJack3D)

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