State Telehealth Policies’ Impact on Care Access and Mental Health Across Rural and Non-rural Populations

Project Overview

Telehealth can improve mental health care access in rural areas where mental health workforce shortages persist and where suicide rates are disproportionately high. The COVID-19 pandemic drove states to expand policies encouraging the delivery of telehealth services, such as Medicaid reimbursement of audio-only telehealth, parity in payment for telehealth by private payors, and regulations to deliver tele-psychological services across state lines. Substantial variation exists in policy adoption across U.S. states, which for the first time allows for naturalistic study. Telehealth policy adoption can improve health care access and outcomes, but results may vary by rurality due to preexisting access barriers (e.g., lack of broadband internet). This proposal aims to understand how rurality moderates the effect of state telehealth policy changes on patient-reported care access, physical and mental health outcomes, and functioning. By characterizing states’ telehealth policies, we can measure whether policy effects improve outcomes equally across rural and non-rural populations to help policymakers target telehealth laws more effectively.