Rural telehealth use for mental illness sees uptick of 45% yearly: 10 study insights

A new study, published in Health Affairs, examines telehealth use among Medicare beneficiaries suffering from mental illnesses across the United States.

Currently, Medicare provides coverage for telehealth use among mental health patients in rural areas. However, the interaction with the provider must occur via live videoconference from a clinic or facility, not from the patient's home. In 2015, Medicare allowed a limited exception for urban patients who receive care at certain ACOs.  

Researchers analyzed Medicare Part B claims from 2004 to 2014 to identify fee-for-service Medicare beneficiaries who lived in a rural community — around 31.7 percent of all fee-for-service Medicare beneficiaries. They included Medicare beneficiaries diagnosed with any mental illness and those diagnosed with serious mental illness in the study. Schizophrenia, psychotic disorders, bipolar disorder and depression with psychotic features were the serious mental illness diagnoses included in the study.

Here are 10 insights:

1. Of all rural Medicare beneficiaries in 2014, 1.65 million had a mental health diagnosis, and 424,385 had a diagnosis of a serious mental illness.

2. Around 1.5 percent of beneficiaries diagnosed with any mental illness and 3.7 percent of those diagnosed with serious mental illness used telehealth services.

3. The most common primary diagnoses on the telehealth visit claims were major depressive disorder and bipolar disorder as well as schizophrenia.

4. Beneficiaries with any mental illness who did receive a telehealth visit were more likely to be younger than age sixty-five and be eligible for Medicare because of disability.

5. From 2004 to 2014, the number of telehealth visits among rural patients with any mental illness rose by 45.1 percent annually, from 2,365 visits in 2004 to 87,120 visits in 2014.

6. Among rural patients with serious mental illness during the same period, telehealth use rose from 1,040 visits to 50,050 visits between 2004 and 2014, an increase of 49.3 percent per year.

7. However, there was significant variation in rural telehealth use across states. Telehealth services were not used for mental healthcare in Connecticut, Delaware and Rhode Island. While in Iowa and South Dakota, there were more than 10 visits per 100 beneficiaries with any mental illness.

8. Similarly, there was discrepancy in rural telehealth use across states among serious mental illness beneficiaries. Nine had more than 25 visits per 100 beneficiaries with serious mental illness, while four states and the District of Columbia had none.

9. States with a telemedicine reimbursement parity law had a higher rate of telehealth visits for mental illness as compared to states without such laws.

10. In 2014, 93.5 percent of telehealth visits for mental health occurred between beneficiaries and telehealth providers in the same state.

More articles on telehealth:
FCC seeks data on telehealth, broadband availability
45% of providers 'just beginning' virtual care pilot projects
Santana Telehealth Project receives 2017 ATA Humanitarian Award

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