Federally Qualified Health Centers provide healthcare services to nearly 30 million patients in the United States, many of whom are low income, use Medicaid or the Children's Health Insurance Program, or are uninsured. Behavioral healthcare is a significant challenge for these vulnerable patient populations; a lack of local providers means many who need mental health services go without.
During a July webinar hosted by Becker's Hospital Review and sponsored by Amwell, a panel of experts discussed the increasing adoption of telehealth by FQHCs, especially for behavioral health, to improve patient care. The panelists were:
- Maureen Meyer, consultant, Grants & Public Funding, Amwell
- Brian Donahue, senior director, Amwell Psychiatric Care
- Matt McCormick, vice president, Amwell Psychiatric Care
Four key takeaways were:
1. Pre-pandemic, FQHC telehealth services were limited. Only 43 percent of health centers used telemedicine before the pandemic, mainly for patients at remote locations (60 percent) and to see specialists at other facilities (56 percent), according to data cited by the panelists. While primary care and chronic condition telehealth visits were offered, the most common telehealth service was for behavioral health, with a focus on mental health. The communities served by FQHCs have a disproportionate percentage of people in need of behavioral health services, but local providers are not always available. "This includes psychiatry; psychiatrists are hard to source in a lot of areas, and that is a great use for telehealth," Ms. Meyer said.
2. Key regulatory changes are helping FQHCs overcome some of the historical barriers to telehealth. Key regulatory changes made in response to the pandemic are making it easier for FQHCs to move past major policy barriers to telehealth. Lack of, or limited, reimbursement was a major problem for FQHCs that wanted to provide telehealth. With the pandemic, CMS increased and extended reimbursement for telehealth services. Site restrictions have also been lifted, as a waiver allows FQHCs to serve as a distant site for telehealth, freeing clinicians to see patients at home instead of at the center.
3. Behavioral health care wait times are increasing, while quality of care decreases. Psychiatric care is experiencing increasing demand and a shortage of providers. "The increase in demand for behavioral healthcare is leading to a lot of problems within our emergency departments," Mr. Donahue said. "This leads to lower-quality care, as well as lost revenue." In the scheduled care space, behavioral health providers are overburdened, leading to attrition of providers. Replacing a psychiatrist is not only costly, but it also affects patient wait times.
4. An end-to-end telepsychiatry solution addresses behavioral health gaps. To improve patient behavioral healthcare, Amwell offers FQHC partners an end-to-end telepsychiatry solution, bringing together not just providers and services but strategy, infrastructure and purpose-built devices that allow patients access to telehealth. The Amwell Psychiatric Medical Group extends the FQHC partner's psychiatric services, adapting to the center's needs and using whatever technology solutions the partner uses. "We are hardware and software agnostic. We're also EMR agnostic; we will document in the native EMR," Mr. McCormick said.
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