The COVID-19 pandemic, which disrupted nearly every facet of society, proved to be the inflection point for telehealth in the United States. While telehealth technology has existed for years, its widespread adoption in behavioral health care has long been slow and hesitant. However, when the pandemic forced a shift to remote care models, telehealth rapidly became the cornerstone of behavioral health delivery. The changes brought about by this sudden shift are proving to be permanent, and stakeholders across the industry are now grappling with what comes next for the virtual care model.
Telehealth in behavioral health care is not a passing trend. Payers, providers, and patients have quickly adapted to remote care, and most experts agree that the shift to virtual services is here to stay. But, while the long-term future of telehealth in behavioral health remains uncertain, one thing is clear: the relationship between payers and providers will play a pivotal role in maximizing the benefits of telehealth moving forward. As stakeholders continue to work through the nuances of virtual care, they are committed to optimizing telehealth’s effectiveness and improving outcomes for patients.
Telehealth Adoption and Utilization: A Dramatic Shift
Before the pandemic, behavioral health services provided via telehealth were relatively uncommon. The reasons for this included concerns about the effectiveness of virtual care for mental health, regulatory hurdles, and a general preference for in-person care. However, when COVID-19 shut down in-person care options and limited access to traditional services, telehealth emerged as a lifeline for both patients and providers. What began as an emergency response to a global health crisis has since evolved into a permanent aspect of care delivery.
The results of this sudden shift in care delivery are striking. According to Susan Coakley, interim president at Beacon Health Options, the pandemic has led to a dramatic increase in telehealth utilization, with outpatient telehealth visits seeing a staggering 75% increase compared to the previous year. Coakley acknowledged that, although inpatient numbers have decreased, the lengths of stay for those in need of inpatient services have become longer, and readmission rates have increased. Despite this, the increased use of telehealth has proven to be a valuable tool for managing outpatient care.
Similarly, Rebecca Schechter, CEO of Optum Behavioral Health, shared insights into the surge in telehealth usage. “The only variation I would add is, as we looked at the surge of and the use of telehealth, particularly in outpatient, we also saw an increase in the first-time users,” Schechter said. Optum, which experienced similar trends, noted that 56% of new users who had never received behavioral health care before the pandemic turned to telehealth for their services.
What’s more, Optum saw the proportion of telehealth claims rise from a single-digit rate before the pandemic to over 50% today. Schechter characterized the past several months as a true inflection point for the behavioral health industry. It’s clear that the adoption of telehealth for behavioral health care is no longer a temporary solution, but a fundamental change in how care is delivered.
Payer-Provider Collaboration: The Next Evolution of Telehealth
One of the key takeaways from the recent Payer’s Behavioral Health Management and Policy virtual event was the recognition that telehealth’s future is not only about continued adoption but also about improving collaboration between payers and providers. Stakeholders from across the behavioral health ecosystem are acknowledging that there is still work to be done to maximize the effectiveness of telehealth and align incentives for optimal patient outcomes.
Susan Coakley, for example, highlighted that Beacon Health Options will continue to “actively use telehealth and get smarter about it.” She added that the next step will involve closely working with provider partners to measure outcomes and ensure that telehealth is used as effectively as possible. Coakley’s vision for the future of telehealth involves not just the continuation of virtual care but also a deeper focus on outcomes to ensure that the care provided via telehealth is truly helping patients improve their mental health and wellbeing.
Rebecca Schechter echoed this sentiment and added a critical point: going forward, behavioral health payers and providers will need to work more closely together to optimize the delivery of services. “There are walls of money entering the provider ecosystem, with plenty of solutions and point solutions being developed,” Schechter said. “Thinking through how we wire that system more intelligently, how we incent players in that system more intelligently, and how we connect the providers with the payers is an area that we’re looking to innovate and move into aggressively.”
Telehealth’s future is not just about increasing the number of virtual visits; it’s about refining the system to ensure that the right care is being delivered, that it is effective, and that it meets the needs of patients. For this reason, better payer-provider collaboration is crucial. As the number of virtual care options grows, payers and providers will need to work together to ensure that these options are integrated into existing systems, and that they align with the goals of both the payers and the patients they serve.
Aligning Incentives: The Key to Success
A major challenge in the transition to virtual care lies in aligning the incentives of payers and providers. As Rebecca Schechter noted, the behavioral health industry is witnessing an influx of “point solutions,” which are specialized tools or services that address specific aspects of care. While these solutions can be incredibly helpful in addressing patients’ unique needs, they are often disconnected from one another, and without proper integration, they risk becoming fragmented.
Schechter predicts that a key area of innovation will be around aligning incentives between payers and providers to connect these solutions. By doing so, payers can help their clients and members navigate the growing landscape of behavioral health services and point solutions, ensuring that they receive the right care at the right time.
The integration of telehealth services into this system will be critical, as virtual care platforms must be designed to seamlessly work with other point solutions and behavioral health programs. This collaboration will require a reevaluation of payment models, and it is likely that payers and providers will need to create new payment structures that reward collaboration and outcomes, rather than simply reimbursing based on the volume of services provided.
The Future of Telehealth: Challenges and Opportunities
While there is no question that telehealth is here to stay, there are still challenges to address in order to make it a truly effective solution for behavioral health care. For one, telehealth will need to be integrated more deeply into the overall health system to ensure that it is not treated as a separate or secondary service. This will involve not only payer-provider collaboration but also coordination between behavioral health services and medical services, as many individuals with behavioral health conditions also have chronic medical conditions that require integrated care.
There is also the challenge of access and equity. Although telehealth has expanded access to care for many individuals, especially those in rural or underserved areas, there are still gaps in terms of digital literacy, internet access, and technological infrastructure. As the shift to virtual care continues, these barriers must be addressed to ensure that all patients, regardless of their background or resources, have equal access to high-quality care.
Despite these challenges, the opportunity for innovation in behavioral health care is vast. With the increased use of telehealth, there is now the chance to develop new models of care that are more patient-centered, cost-effective, and efficient. This includes the potential for more personalized care, better integration of services, and more effective prevention strategies. In the coming years, payers and providers will need to continue innovating to meet the evolving needs of patients and ensure that telehealth becomes an integral part of the behavioral health care system.
Conclusion
The COVID-19 pandemic has accelerated the adoption of telehealth in behavioral health care, and there is no turning back. As the industry looks to the future, the key to success will lie in improving collaboration between payers and providers, aligning incentives, and ensuring that telehealth is integrated into a holistic, patient-centered care system. With continued innovation and a focus on outcomes, telehealth has the potential to revolutionize the way behavioral health services are delivered, improving access, quality, and efficiency for patients across the country. As stakeholders continue to refine the telehealth model, the behavioral health industry stands poised for a future that is more connected, coordinated, and effective than ever before.
