Telehealth for behavioral healthcare has increased in popularity since the COVID-19 pandemic. Several regulatory flexibilities have made it easier for providers to offer telehealth to patients, but these are set to expire at the end of the year unless Congress renews them.
Here are five things to know about the current state of telehealth for behavioral care:
- In May, the House Ways and Means Committee advanced legislation to extend pandemic-era telehealth flexibilities for two more years. The provisions would allow Medicare beneficiaries to receive telehealth behavioral care from any provider, regardless of location, and a relaxation of requirements on in-person visits.
- The extension will likely have to wait until the end of the year to get full approval from Congress, as part of a lame-duck session healthcare package. In April, HHS Secretary Xavier Becerra told lawmakers the extension is vital for mental healthcare.
- The availability of telehealth for mental healthcare declined slightly after the end of the COVID-19 public health emergency, a study published in JAMA Health Forum July 10 found. The study found larger declines in audio-only telehealth services, and telehealth services for comorbid alcohol use disorder. Public facilities were more likely to stop offering telehealth services than private facilities, the study found.
- More vulnerable populations are more likely to use audio-only telehealth, a study published in JAMA Health Forum found.
Dhruv Khullar, MD, director of the Physicians Foundation Center for the Study of Physician Practice and Leadership at Weill Cornell Medical College, and a co-author of the study, told Becker's people who are older, have more medical conditions, or are in racial or ethnic minority groups are more likely to use audio-only telehealth than other groups.
"We believe that if these provisions are allowed to expire at the end of the year, those would be the groups that are disproportionately affected that are relying on audio-only visits in a way that other patients aren't," Dr. Khullar said.
Some people may prefer audio-only visits because they have limited internet access, or are unfamiliar with video technology. Others may not have a comfortable place in their home to be on video, Dr. Khullar said.
More research is needed on the overall impacts telehealth has on quality and cost of care, he said.
"But I think for the time being, it makes sense to continue coverage for this so we can see really, how this is impacting people, so it doesn't come to an end for a lot of patients," Dr. Khullar said.
5. CMS has moved to make opioid use disorder treatment more accessible through telehealth. In a proposed rule published July 10, the agency pitched making permanent the current flexibility allowing OUD treatment providers to provide periodic assessments for patients through audio-only telehealth. The proposal would also allow intake appointments for OUD treatment over two-way audio-video communication.