The adoption of telehealth for behavioral health services has accelerated dramatically over the past few years, with commercially-insured patients leading the surge. The University of Pittsburgh Medical Center (UPMC), a major health system operating 140 hospitals across Pennsylvania, Ohio, West Virginia, and Maryland, recently shared that between 70 and 80 percent of behavioral health visits within their commercial insurance network now occur via telehealth. This transformation reflects a profound shift in how patients access mental health and addiction treatment services, making care more accessible and convenient.
James Schuster, chief medical officer of UPMC’s insurance services division, provided these insights during a virtual event hosted by America’s Health Insurance Plans (AHIP). Schuster explained that while telehealth saw meaningful uptake among Medicare and Medicaid populations during the pandemic, the most substantial increase in telehealth for behavioral health has occurred among commercially-insured individuals. This demographic shift underscores changing attitudes and increased comfort with virtual behavioral health services.
Explosive Growth of Telehealth Since 2020
According to a report from McKinsey & Company, telehealth usage has grown by an astonishing 38 times since 2020. This rapid increase can largely be attributed to the COVID-19 pandemic, which created an urgent need to rethink healthcare delivery methods. In response, many states and federal agencies relaxed restrictions, enabling healthcare providers to offer telehealth services across state lines and expanding the range of services eligible for reimbursement.
Government programs such as Medicare and Medicaid have expanded telehealth benefits, allowing beneficiaries to receive telebehavioral health services in their own homes. This change has significantly lowered traditional barriers such as transportation, scheduling conflicts, and social stigma associated with seeking in-person behavioral health care. Moreover, bipartisan legislative efforts are underway to make many of these telehealth flexibilities permanent, signaling a sustained commitment to integrating telehealth for behavioral health into standard care practices.
Finding the Right Balance: Telehealth and In-Person Care
Despite the rapid adoption of telehealth, UPMC acknowledges that in-person behavioral health care remains essential for many patients. Schuster discussed UPMC’s efforts to develop flexible guidelines that help determine when telehealth is appropriate and when in-person care is necessary. These guidelines are intended to be adaptive rather than rigid, allowing healthcare providers to use clinical judgment and patient preference to strike the right balance.
The aim is to ensure that telehealth for behavioral health complements rather than replaces face-to-face interactions. Schuster emphasized that the evolving nature of these guidelines reflects a broader industry understanding that a hybrid model—combining telehealth and in-person care—can deliver the best outcomes for patients.
Telehealth’s Growing Role in Addiction Treatment
One of the most notable areas of growth for telehealth is addiction treatment. For the first time in August 2021, substance use disorder (SUD) diagnoses ranked among the top five treatment claims processed via telehealth, highlighting increasing acceptance of virtual care for addiction recovery.
Innovative startups like Quit Genius and Workit Health have raised significant funding—$64 million and $118 million respectively—to scale their telehealth addiction treatment platforms. Similarly, Ophelia Health raised $15 million in early 2021 and an additional $50 million later that year, demonstrating strong investor confidence in digital SUD treatment. Established organizations like the Hazelden Betty Ford Foundation are also investing in telehealth, with plans to offer virtual addiction treatment services nationwide in the coming years.
UPMC’s Success with Medication-Assisted Treatment Through Telehealth
UPMC’s insurance division, which covers close to 4 million members, has partnered closely with its provider network to deliver medication-assisted treatment (MAT) through telehealth during the pandemic. Schuster described this initiative as particularly successful, noting that telehealth has enabled patients to begin and continue MAT more easily by reducing common barriers such as travel, time constraints, and stigma.
This success with telehealth-delivered MAT underscores the potential of virtual care to handle complex treatment regimens and improve adherence and retention, which are critical factors in addiction recovery.
Overcoming Engagement Challenges with Human Interaction
Despite its many benefits, telehealth for behavioral health is not without challenges. Schuster acknowledged that purely digital platforms can struggle to engage patients effectively. Research suggests that combining telehealth with personal interaction—such as regular contact with therapists, coaches, or support staff—is key to maintaining patient engagement and improving outcomes.
This understanding is driving innovation in telehealth platforms, focusing on creating experiences that are both user-friendly and personal. By blending technology with human support, providers aim to address issues like isolation and motivation that can arise during virtual treatment.
The Future of Telehealth in Behavioral Health Care
The COVID-19 pandemic fundamentally changed perceptions around telehealth for behavioral health. Schuster expressed strong confidence that telehealth will continue to expand and improve, becoming a permanent and integral part of behavioral health care.
“Everyone’s experience during the pandemic made us more comfortable that more can be done via tele-platforms than we thought possible before,” he said. The industry is now focused on optimizing telehealth platforms, refining clinical guidelines, and advocating for policies that support sustainable virtual care.
Health systems like UPMC are poised to lead this transformation by leveraging telehealth to increase access, improve patient engagement, and deliver high-quality behavioral health care to broader populations.
