COVID-19 Drives Explosive Growth In Telehealth-delivered Behavioral Health Care

A dramatic 45-fold surge in telehealth-delivered behavioral health services since the onset of the COVID-19 pandemic highlights the urgent need for innovative solutions to address the escalating behavioral health crisis in the United States, according to new data from market research firm Trilliant Health.

Trilliant Health carried out a comprehensive analysis of healthcare usage patterns and behaviors between 2019 and 2022, drawing on data from their proprietary all-payer claims database and a range of third-party sources. The research uncovered that by Q2 2022, the volume of behavioral health visits had risen by 18% compared to pre-pandemic figures. Moreover, demand for these services outpaced the national average growth rate in nine out of the ten most populous metropolitan core-based statistical areas (CBSAs).

In response to the surge in demand, telehealth adoption for behavioral healthcare saw a tremendous increase. Prior to the pandemic, a mere 1% of all behavioral health visits took advantage of telehealth, but by Q2 2022, this number had soared to 32.8%. Additionally, the share of telehealth visits associated with behavioral healthcare leaped from 34.4% in Q2 2019 to 63.8% in Q2 2022, representing a growth of almost 30 percentage points. Regarding payers, traditional Medicare observed the highest proportion of telehealth-delivered behavioral health services, with an increase from under 2% in Q1 2019 to 48.6% in Q2 2022. This was followed by Medicare Advantage (40.1%), Medicaid (36.7%), and commercial insurance (31.8%).

Contrastingly, even as demand and utilization of behavioral health services expanded, investments in digital behavioral healthcare witnessed a downturn. Private equity investments in the field, encompassing virtual care and digital health platforms, amounted to $2.6 billion in 2022, reflecting a 52.9% decrease from 2021. Additionally, there was a decrease from 354 deals in 2021 to 289 deals in 2022.

The use of telehealth for prescribing stimulants also rose during the pandemic, reaching 38.4% in 2022. However, these rates may face a significant decline in the future. The US Drug Enforcement Administration (DEA) recently released proposed rules that limit the virtual prescription of certain controlled substances following the COVID-19 public health emergency. The agency plans to permanently allow telehealth consultations for controlled medication prescriptions only if the medical practitioner has previously performed an in-person examination of the patient.

These proposed rules were released after some direct-to-consumer telemental healthcare companies, such as Done and Cerebral, came under federal scrutiny over their prescribing practices. Both companies, which offer treatments for attention-deficit/hyperactivity disorder (ADHD), faced probes from federal agencies over reports that they overprescribed certain controlled substances.

As the pandemic continues to reshape the behavioral health landscape, telehealth-delivered services have become a crucial solution. However, addressing the increasing demand for services, access to providers, and the widening gap between patient needs and available resources will require a multifaceted approach that considers the ever-changing regulatory environment and investment trends.