Growth and Disparities in Mental Health, Telemedicine, and Telemedicine Mental Health Usage between 2013 and 2018 among Disabled Medicaid Clients in Urban, Suburban, and Rural Texas Counties: A Cohort Study (Preprint) Institutional Repository Document

Healthcare services delivered through remote technology, known as telemedicine or telehealth, have been growing across the country and can improve access to care for needy populations. However, uptake and the growth in telemedicine use has not been well documented.

To examine the disparities in the growth in telemedicine use and telemedicine use for mental health care in rural and urban Texas counties.

Texas Medicaid claims data were analyzed from September 1, 2012 to August 31, 2018 for Medicaid members enrolled due to a disability. We analyzed the growth in telemedicine care based on geography and mental health status.

Medicaid client panels grew at 132% for telemedicine providers, with urban clients growing the fastest (255%). Clients with a telemedicine visit for a mental health condition grew by 77%. Telemedicine clients with mental health diagnoses tended to have 2 to 3 more visits per year than non-telemedicine mental health clients.

Growth in telemedicine care was strong in urban and rural areas between 2013 and 2018. Those with a mental health condition who received telemedicine care had a higher number of total mental health visits compared to those without telemedicine care. These findings hold across all geographic groups and suggest that mental health telemedicine visits did not substitute for face-to-face mental health visits.