By Jette Campbell & Peter Keogh, Carl Marks Advisors
In a time of lockdowns and concerted efforts to avoid exposure to COVID-19, telehealth is not only the hottest topic in healthcare, but also a boon to providers attempting to treat behavioral health patients in a holistic and cost-effective way.
All signs indicate telehealth will continue to expand in use and popularity, even after the pandemic is hopefully in the rear-view mirror. After all, telehealth has proven to be popular with patients, as a recent McKinsey survey found that 74% of telehealth users during the pandemic reported high satisfaction with the care they received. And, as long as government regulations allow, telehealth can provide behavioral health patients with convenient, continuous care, and providers with an efficient and cost-effective treatment option they should make a long-term investment in.
Convenience and Continuity for Patients
Technology is no longer a significant barrier for most American families when it comes to telehealth. Most have or can access doctors via text, videoconference, mobile apps, and other types of web- and telephone-based systems. For behavioral health patients in particular, telehealth’s convenience can improve continuity of care, allowing for better health outcomes.
These patients can continue to meet with the same doctors and therapy groups for much longer than if they had been treated at an out-of-state facility and discharged. And there are the added benefits of being treated in the privacy one’s own home without added potential exposure to illnesses like COVID-19.
Digital Solutions Drive Providers’ Revenue and Efficiency
While the vast benefits of telehealth to patients should not be understated, the advantages to behavioral healthcare providers may be even greater. Clinicians are able to expand their patient base beyond brick-and-mortar facilities, extend hours, and create new and more convenient models for their patients. Telehealth also reduces per-patient and overhead costs relating to facilities and transport, and can significantly increase their access to qualified professionals.
The benefits also extend to staffing. In the past, behavioral health providers – particularly in rural and underserved communities – may have experienced difficulty hiring and retaining qualified medical personnel. Now, with remote employment, they are able to hire anyone licensed in their respective state to provide service on a part- or full-time basis.
Another extremely important advantage of telehealth is that it allows behavioral health providers to accelerate their embrace of digital solutions, including documentation of patient records and billing. Not only does this mean better tracking of patients from intake to discharge, and improved continuum of care, but it also has financial benefits. Improved documentation can increase revenue, improve the efficiency of internal operations, and significantly accelerate amount and speed of reimbursement (inadequate documentation is the leading factor preventing timely reimbursement). In an industry with tight profit margins, this is a not insignificant advantage.
Unique Challenges of Remote Care
When discussing the myriad benefits of telehealth in behavioral treatments, it is critical to understand and evaluate the potential costs – especially for smaller facilities and solo practices. As with any technology, there is an initial investment required to get a system running plus ongoing maintenance costs. And, like the rest of the practice, any system a provider chooses must comply with strict privacy laws and HIPAA, which may be different than those for in-person treatment.
Providers should also establish training programs for clinic staff since virtual treatment requires a different skillset than in-person. As virtual classroom experiments in the spring of 2020 taught us, there are unique pitfalls associated with a remote environment that need to be accounted and prepared for.
To set themselves up for continued success, providers should offer and support ongoing educational initiatives for staff, healthcare administrators, and health officials. Enhancing knowledge around rules and regulations for telehealth treatment and best practices is critical.
One area of particular importance is licensure. Though this may change in the future, today there are strict rules in place that prevent clinicians from treating virtual patients across state boundaries without a license in the state where the patient is located. Some of these interstate licensing laws have been relaxed due to the pandemic but are not yet permanent or codified into law.
Compensation is another area to be aware of. While the U.S. government acted quickly during the pandemic to ease regulations around telehealth and the Centers for Medicare & Medicaid Services (CMS) expanded the telehealth services that are covered for reimbursement, many of these changes are not permanently codified. In other words, it is not yet known how providers will be paid for telehealth services in the long-term.
Finally, behavioral health providers should take into account that, though technology is not a barrier to a majority of Americans, there are still populations (particularly those who are lower-income or live in rural areas) who lack access to reliable broadband internet and mobile devices. Just as not all patients can practically be served by telehealth, not all aspects of behavioral health treatment lend themselves to being remote or virtual. In addiction care, for example, a brick-and-mortar facility is important to maintain as the most efficacious way to monitor patients and help with the detoxification process.
Behavioral health providers should think about telehealth as an excellent a la carte option on their menu of holistic treatment options. While it cannot replace other treatment modalities, it is a convenient and popular tool they can –and should – use to better serve patients. If providers adhere to regulations, telehealth can continue to boost revenue and increase operational efficiency. However, there are also start-up costs, preparation, and training that needs to be prioritized for the technology to be effective in treating behavioral health issues.
The true cost of behavioral health issues like addiction to the American healthcare system and our social fabric is far greater than the cost of treatment. By enabling providers to reach more patients and vastly expand continuity of care at lower cost, the growth of telehealth is proving a true silver lining to the dark cloud of COVID-19.