The rise in telemedicine over the past several years hasn’t translated to more behavioral healthcare access in rural areas, according to a March 5 study in JAMA Network Open.
Researchers from Boston-based Harvard Medical School and Providence, R.I.-based Brown University analyzed Medicare billing records of 17,742 mental health specialists from 2018 to 2023.
“We had thought the dramatic shift from in-person care to telemedicine among mental health specialists would lead to them caring for substantially more patients in rural communities,” said study author Drew Wilcock, PhD, a lead research scientist at Brown’s School of Public Health, in a March 5 news release. “Unfortunately, we just don’t see it.”
Compared to mental healthcare providers who used telehealth less, their peers who leaned more heavily on virtual visits only saw about 0.9 percentage points more rural patients, 0.1 percentage points more patients from areas lacking behavioral healthcare access, and 2.6 percentage points more patients located 20 miles or more from the specialists, the researchers found. But those increases mostly reflected existing patients who had moved away from their providers and continued care virtually.
Specialists using telehealth also saw 3.6 percentage points fewer new patients overall, suggesting that virtual care may help maintain long-term relationships with existing patients but lower the ability to take on new patients, the researchers said.
The authors recommended that states ease licensure practices that prevent more clinicians from practicing across state lines.
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