Top 10 findings on telemedicine, mental disorders and rural populations

Telemedicine for mental health allows rural patients to receive high quality care—regardless of geographic limitations. A study in Health Affairs investigates "telemental health" by outlining the ins and outs of services offered to rural patients.

Analyzing Medicare Part B fee-for-service claims from 2004 to 2014, the study included statistics on the use of telemental care from beneficiaries in rural communities diagnosed with any serious mental illness.

Findings included:

1. Of Medicare beneficiaries in 2014, 14.5 percent were diagnosed with a mental illness, with 3.7 percent considered serious.
2. In 2014, 1.5 percent of beneficiaries diagnosed with a mental illness and 3.7 percent of those with a serious illness received a telemental health visit.
3. There were 5.3 telemental health visits per 100 beneficiaries in 2014, an increase from 0.2 visits in 2004.
4. The most common mental illnesses treated were major depressive disorder, bipolar disorder and schizophrenia.
5. Compared to beneficiaries with any mental illness who did not receive a telemental health visits, those who did were more likely to be less than 65 years in age, eligible for Medicare because of a disability and live in a poorer community.
6. From 2004 to 2014, total telemental health visits increased from 2,365 to 87,120. Visits for those with serious mental illnesses increased from 1,040 to 50,050.
7. In 2014, states with a telemedicine parity law had an increased number of telemental health visits compared to states that did not.
8. States varied on their rates of telemental health visits. Connecticut, Delaware and Rhode Island reported no telemental health visits while Iowa and South Dakota reported more than 10 visits per 100 beneficiaries with any mental illness.
9. More than 93 percent of telemental health visits in 2014 occurred with the beneficiary and provider in the same state.
10. The average distance between the beneficiaries’ residence and telemental health provider was 103 miles.

“Telemental health use among rural Medicare beneficiaries is growing rapidly and is serving a particularly disadvantaged population of disabled rural beneficiaries,” concluded Ateev Mehrotra, MD, MPH, an associate professor of health care policy and medicine at Harvard Medical School and a hospitalist at Beth Israel Deaconess Medical Center, first author on the study and colleagues. “Despite that rapid growth, a relatively small minority of rural Medicare patients with a diagnosis of mental illness receive a telemental health visit, and the rates of use are uneven across the country. Whether—and if so, how—the expansion of telemental health is improving access and outcomes for patients remains unclear, but this early analysis can help guide future policy and regulatory decisions at the state and federal levels.”