Two new KFF analyses study how state Medicaid packages have utilized telehealth to extend entry to behavioral well being care throughout the pandemic and the methods they’re using to handle workforce shortages in behavioral well being.
The research come because the 2022 Bipartisan Safer Communities Act laws requires the federal authorities to subject telehealth steerage by the top of 2023, and the omnibus spending invoice that Congress handed final month included a number of provisions affecting behavioral well being telehealth and workforce points. They embody necessities or funding associated to supplier directories, disaster providers, digital peer psychological well being helps, will increase in new psychiatry residency positions, and expansions in entry to suppliers who prescribe sure medicines for opioid use dysfunction.
Each new analyses draw their findings from KFF’s Behavioral Well being Survey of state Medicaid packages, fielded as a complement to our annual price range survey of Medicaid officers.
The primary research finds that states’ enlargement of telehealth has taken quite a lot of varieties, together with the addition of audio-only protection of behavioral well being providers; the enlargement of the forms of behavioral well being providers that may be delivered by way of telehealth (e.g., group remedy or medication-assisted remedy); and the enlargement of supplier varieties that could be reimbursed for telehealth supply of behavioral well being providers (e.g., marriage and household therapists, dependancy specialists, and peer specialists).
States reported excessive utilization of telehealth for behavioral well being care throughout all or most populations served by Medicaid. Some states discovered that utilization was increased in rural areas, amongst youthful enrollees, or amongst White people. Utilization has declined from peak ranges however stays increased than earlier than the pandemic. Most states report that they’re prone to maintain lots of the pandemic-driven telehealth coverage expansions in place.
Even because the pandemic exacerbated psychological well being and substance use points among the many public, documented workforce challenges elevate obstacles to care, in Medicaid and past. Practically half of the US inhabitants – 47 p.c, or 158 million individuals – dwell in a psychological well being workforce scarcity space.
Workforce challenges are widespread and transcend Medicaid, however shortages could also be worsened in Medicaid, significantly given low participation charges amongst psychological well being suppliers.
The second KFF evaluation finds that some state Medicaid packages are implementing methods to handle the behavioral well being workforce scarcity, together with:
- Rising supplier reimbursement charges—two-thirds of responding states reported price will increase, which can encourage suppliers to take part in Medicaid.
- Extending the workforce by reimbursing for brand spanking new supplier varieties, loosening restrictions on in-person necessities, and concentrating on outreach to recruit new suppliers.
- Decreasing administrative burdens although steps that will embody streamlining documentation, centralizing enrollment processes, and asking suppliers for his or her ideas on Medicaid’s administrative course of.
- Incentivizing supplier participation by way of the adoption of measures akin to immediate cost insurance policies and mortgage reimbursement.
For extra knowledge and analyses about behavioral well being, telehealth and Medicaid, go to kff.org
