Mental health and substance use visits were identified based on the primary ICD-10-CM diagnosis code listed for the visit. This analysis looks at outpatient visits during five six-month periods between March 2019 and August 2021, using data from Cosmos, a HIPAA-defined Limited Data Set of more than 126 million patients from over 156 Epic organizations, including 889 hospitals and 19,420 clinics across all 50 states. Many state Medicaid programs reported that telehealth has had particular value in maintaining or improving access to such services during the pandemic. Similarly, Medicaid expanded coverage of telehealth services during the pandemic for mental health and substance use services. Thus far into the pandemic, some private payers have improved coverage for mental health and substance use, removing pre-pandemic restrictions on coverage for these services via telehealth. Telehealth has played a particularly significant role in meeting the need for mental health services. Over 20% of adults reporting poor mental health also report not receiving counseling or therapy during the pandemic. reporting symptoms consistent with depression or anxiety disorder since April 2020. The COVID-19 pandemic has taken a toll on the nation’s mental health, with 3 in 10 adults in the U.S.
While many continue to envision an expanded role for telehealth in the delivery of care following the pandemic, there remains considerable uncertainty in what services will be available, where and how providers will be able to practice, how benefits will be structured, and how providers will be paid. As in-person care resumed, telehealth began to represent a smaller share of outpatient care ( 8% between March and August 2021). At its pandemic peak, telehealth represented 13% of outpatient visits between March and August of 2020. While many employer health plans covered telehealth prior to the pandemic, utilization of these services was relatively low, accounting for less than 1% of outpatient visits. There has been a rapid increase in the use of telehealth thus far into the COVID-19 pandemic for both mental and physical health concerns.
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