Expansion of Telehealth Availability for Mental Health Care After State-Level Policy Changes From 2019 to 2022

• DOI: 10.1001/jamanetworkopen.2023.18045
• Publication Date: 2023-06-13T15:01:16Z
• Authors: Ryan K. McBain; Megan S. Schuler; Nabeel Qureshi; Samantha Matthews; Aaron Kofner; Joshua Breslau; Jonathan H. Cantor
• Keywords: Telehealth; Licensure; Prior authorization; Quarter (Canadian coin)

Importance Although telehealth services expanded rapidly during the COVID-19 pandemic, association between state policies and availability has been insufficiently characterized. Objective To investigate associations 4 at outpatient mental health treatment facilities throughout US. Design, Setting, Participants This cohort study measured whether offered each quarter from April 2019 through September 2022. The sample comprised with that were not part of US Department Veterans Affairs system. Four identified different sources. Data analyzed in January 2023. Exposures For quarter, implementation following was indexed by state: (1) payment parity for among private insurers; (2) authorization audio-only Medicaid Children’s Health Insurance Program (CHIP) beneficiaries; (3) participation Interstate Medical Licensure Compact (IMLC), permitting psychiatrists to provide across lines; (4) Psychology Interjurisdictional (PSYPACT), clinical psychologists lines. Main Outcome Measures primary outcome probability a facility offering year (2019-2022). Information on obtained Mental Addiction Treatment Tracking Repository based Substance Abuse Services Administration Behavioral Service Locator. Separate multivariable fixed-effects regression models used estimate difference after vs before policy implementation, adjusting characteristics county which located. Results A total 12 828 included. Overall, 88.1% 2022 compared 39.4% 2019. All associated increased odds availability: (adjusted ratio [AOR], 1.11; 95% CI, 1.03-1.19), reimbursement (AOR, 1.73; 1.64-1.81), IMLC 1.40, 1.24-1.59), PSYPACT 1.21, 1.12-1.31). Facilities accepted as form had lower 0.75; 0.65-0.86) over period, did counties higher proportion (>20%) Black residents 0.58; 0.50-0.68). rural 1.67; 1.48-1.88). Conclusion Relevance this suggest introduced pandemic marked expansion care Despite these policies, less likely be greater CHIP.