Tele-mental health services expand rapidly, but in concentrated pockets

Telemedicine visits are on the rise for rural patients in some areas, but quantifying the benefits of future growth remains tricky, says a new study.

A lot more patients with mental health issues in rural areas are getting help via telemedicine, but the growth has not been geographically uniform, according to a new study.

Published in Health Affairs, the study tracked a 45% rate of annual growth in telehealth visits for mental health claimed via Medicare on an annual basis from 2004 through 2014.

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Even with this growth, however, services only reach a small proportion of those suffering. And the study found a wide variation in use from state to state.

Increased access to telehealth services has become such a hot topic of discussion among lawmakers that some industry watchers have begun to wonder whether it’s on the verge of a bubble, as FierceHealthcare has reported.

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Given the widespread need for mental health services and the relative lack of behavioral health specialists to deliver needed care, telemedicine has increasingly become a tool of choice in rural areas.

While the growth in the use of telehealth visits for rural patients has been swift, the authors noted it has also been concentrated both geographically and among patient populations. Nine states had visit rates of 25 per 100 beneficiaries in 2014, while four states and the District of Columbia had none.

The reasons for state-by-state variation remain unclear, said the authors. They did note, however, that states with telemedicine parity laws, which require payment for telehealth services of Medicaid and/or commercial plans, saw 20% higher use rates than states without such laws.

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The authors also cautioned that while the use of remote behavioral health may improve care for some rural patients who would otherwise be unable to find a specialist close to them, it "does not appear to be greatly expanding the number of rural beneficiaries who receive any mental health specialty care.”

While room for expansion of remote behavioral health services exists, the authors noted it remains difficult to predict the efficacy of any specific effort, as the effect of expanded use of the technology on access and outcomes remains unclear.