- Healthcare providers in Massachusetts are urging state officials to make telehealth more accessible to meet a growing lack of access to mental health services.
At a recent roundtable, representatives of several health systems lamented that the state doesn’t support telemedicine parity, and noted that patients in need of behavioral health often end up in a hospital ER before they can see a doctor.
Several bills before the state Legislature target telemedicine and telehealth coverage, including one sponsored by State Senate Majority Leader Harriette Chandler (D-Worcester) that would force payers to cover telemedicine as they would in-person services.
But despite strong mHealth, telemedicine and telehealth programs in health systems like Partners Healthcare, Beth Israel Deaconess Medical Center, Boston Children’s Hospital and UMass Memorial Medical Center, among others, state legislators have been slow to support the technology.
"On the one hand, we have the technology, but we don't have the payment and regulatory support to do that," Karin Jeffers, who heads the six-clinic Clinical & Support Options in western Massachusetts and serves on the board of the Association for Behavioral Health, told the gathering, as reported by the Worcester Business Journal.
"I've been trying to get a telemedicine bill through this legislature for 10 years, and we've been rather slow in doing it," Chandler replied.
With an opioid abuse epidemic making headlines and a noted shortage of mental health providers, health system officials say this could provide momentum to get something done. And they have support from national organizations like Epstein Becker Green, the Advisory Board Company and the American Telemedicine Association, which has highlighted telemental health as one of the fastest growing telehealth platforms in the country.
"There are questions as to whether or not there are enough beds in the western part of the state, where perhaps there are about 200 or so," said Dr. Mark Keroack of Springfield-based Baystate Health. "Worcester County has built a tremendous number of beds in the last year - I think nearly 200 additional beds - but I don't think it's staffed them to the point where they can begin to accommodate patients, so there's a shortage not only of staffed beds but also of mental health workers, psychiatrists, etc.”
Health systems in other states are using telemedicine to tackle those issues. Just up the highway in Maine, Lewiston-based St. Mary’s Regional Medical Center is parlaying its telepsychiatry program into a statewide video platform that can be accessed by other hospitals in need of emergency psychiatric consults.
“There was a lot of skepticism at first,” Paul Rouleau, RN, director of behavioral operations for St. Mary's Health System and Community Clinical Services, said of the response from other providers. “We reminded them that they didn’t have anyone in person to start with.”
In Wisconsin, Milwaukee-based Wisconsin Lutheran Christian Family Solutions turned to telehealth last year, adding video links to counselors in Indiana, North Dakota, Idaho and even Florida, to improve access in a region where clinics and doctors’ offices are often hundreds of miles apart.
“We have access to a huge market that we don’t have within driving distance of our little clinics,” said Dan Nommensen, LPC, NCC, DCC, coordinator of WLCFS’ member assistance program and a licensed professional counselor. “Why wouldn’t we do this?”
Nommensen said the program does struggle to gain acceptance from payers.
“Some payers are great, while others really haven’t thought about telehealth at all,” he told mHealthIntelligence in a June 2016 interview. “Then there are payers who will reimburse only when it’s on their own approved platforms. It’s hard when we use a HIPAA-compliant procedure and process but a payer says that’s not good enough.”
Back in Massachusetts, Chandler noted other efforts to reform the state’s healthcare system. This week Gov. Charles Baker announced plans to restructure MassHealth, the state’s Medicaid system, into an accountable care system, with 17 participating providers expected to get more than $100 million to improve care coordination, including access to behavioral healthcare.
Telehealth and telemedicine could be the “low-hanging fruit” in those efforts, said Steve Walsh, CEO and president of the Massachusetts Council of Community Hospitals.
Chandler noted others states have adopted new telemedicine and telehealth initiatives, putting Massachusetts on the spot.
"I watch every other state getting involved - it makes a difference," she said.
"We need to be first again," she added. "We need to cut these costs. The costs will kill us, ultimately."