Medicare and virtual mental health care: Who is getting it?

A new analysis of Medicare data shows mental health specialists who embraced telehealth did not see substantially more rural patients

Mario Aguilar covers technology in health care, including artificial intelligence, virtual reality, wearable devices, telehealth, and digital therapeutics. His stories explore how tech is changing the practice of health care and the business and policy challenges to realizing tech’s promise. He’s also the co-author of the free, twice weekly STAT Health Tech newsletter. You can reach Mario on Signal at mariojoze.13.

In today’s edition, important questions about the rapid adoption of health technology. Who is responsible, how is it tested, and who does it benefit? You’re reading the web edition of STAT’s Health Tech newsletter, our guide to how technology is transforming the life sciences. Sign up to get it delivered in your inbox every Tuesday and Thursday. A new analysis of Medicare claims from 2018 through 2023 shows that mental health providers who most enthusiastically embraced telehealth are not seeing substantially more patients in rural and underserved areas.

The findings suggest that while telehealth has seen significant adoption in Medicare since the government insurer expanded coverage during the pandemic, it’s not helping reach the places with the most need. While the study doesn’t arrive at explanations, it makes sense that clinicians who are already in high-demand locally would be more likely to serve people in their own communities, said co-author Ateev Mehrotra, a professor at the Brown University School of Public Health.

Policies that might help include increasing broadband access and facilitating inter-state licensing for providers. The research adds to the growing body of literature suggesting that the boom in virtual mental health care is having uneven benefit. A notable analysis of survey data published last year found that in 2021, “individuals who had a higher income, were employed, and were college educated had significantly higher teletherapy use than their counterparts.” The possibility of using technology to expand mental health access in rural communities has been theorized and explored for decades.

Making it work is another issue. Back in 2021, I wrote about a successful effort to beam big city psychiatrists and psychologists to remote federally qualified health centers to support primary care providers in treating patients with PTSD and bipolar disorder. Among the takeaways of that story was the complexity of coordinating such an arrangement. It takes more than transmission lines and insurance coverage to carry access to underserved areas.

The Food and Drug Administration is cracking down on companies that market compounded GLP-1 obesity and diabetes medications with misleading claims. The regulator has warned over 70 companies since last year. A new analysis by Katie Palmer suggests at least 30% of these companies are affiliated with just four nationwide medical groups. These “white label” medical practices have been essential to the rise of telehealth businesses that make it very easy for people to obtain low-cost GLP-1 drugs.

But as the FDA cracks down on how compounded drugs are marketed, these businesses may find themselves under the microscope as well. Katie’s story explores how the arrangements with white label medical groups work, including interviews with the operators who say they make an effort to vet the telehealth brands they work with. At HIMSS, Epic, Oracle, Amazon, Microsoft, and many other companies have announced new AI agents, or software tools that autonomously complete health care tasks including medial coding, documentation, chart review, scheduling, and more.

But as Casey Ross reports, this rush of new agents comes amid growing concern that automation is being adopted in health care before tech is validated and without sufficient patient input. He looks at two recent studies exploring the topic. Mario Aguilar covers technology in health care, including artificial intelligence, virtual reality, wearable devices, telehealth, and digital therapeutics. His stories explore how tech is changing the practice of health care and the business and policy challenges to realizing tech’s promise.

He’s also the co-author of the free, twice weekly STAT Health Tech newsletter. You can reach Mario on Signal at mariojoze.13. Tech is transforming health care and life sciences. Our original reporting is here to keep you ahead of the curve.

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