Research Finds Women and Providers in Urban Areas Exhibit Higher Adoption of Telehealth Health Practices

New research reveals that female mental health specialists and those practicing in densely populated counties with higher real estate prices showed a greater inclination to shift their practice exclusively to telehealth, as indicated by the findings of a recent study drawing data from the National Electronic Health Records Survey in 2022. This aligns with the overall mental healthcare context, where over a third of mental health visits were conducted through telemedicine in 2021, highlighting the growing dependence on virtual platforms for delivering mental healthcare services.  

This cohort study, utilizing deidentified commercial health insurance claims from OptumLabs Data Warehouse, includes an important period from January 1 to December 31, 2019, and January 1 to December 31, 2022. Mental health specialists, including psychiatrists, psychologists, social workers, and psychiatric mental health nurse practitioners (PMHNPs), were scrutinized based on their transition to fully virtual practices. Clinicians defined as “telemedicine only” conducted over 95% of their visits virtually in 2022. The study comprehensively explored a variety of clinician variables such as specialty, gender, US region, patient demographics, and practice location characteristics, providing a comprehensive view of the transition to telemedicine. 

Among the expansive cohort of 51,309 mental health specialists meeting the inclusion criteria, a notable 13.0% transitioned to telemedicine-only practices in 2022. This change exhibited variability across specialties, with PMHNPs leading at 18.7%, while psychiatrists displayed the lowest adoption rate at 9.1%. The study’s detailed analysis further revealed that female clinicians and those situated in counties with higher housing values and population density were more likely to adopt telemedicine-only practices. Clinicians with a pediatric focus also exhibited a lower likelihood of fully embracing telehealth compared to their generalist counterparts. 

The findings from this study underline the complex nature of the change to telemedicine among mental health specialists. Female clinicians, potentially motivated by a pursuit of greater work-life balance and flexibility, and those located in urban areas with higher living costs, have emerged as frontrunners in fully embracing telemedicine. This comprehensive analysis prompts considerations about the long-term implications of telehealth adoption, especially as Medicare introduces new requirements for annual in-person visits and state Medicaid programs demand in-person options for telehealth visits. 

Understanding the nature of virtual-only practices becomes a priority as telemedicine continues to evolve, particularly in mental health care. The study’s findings not only highlight the unique characteristics of mental health specialists leading this transformative transition but also raise important questions about regulatory compliance, patient preferences, and potential impacts on clinician burnout and retention. The transition to virtual-only practices presents a variety challenges, emphasizing the need for ongoing research and strategic planning to manage the advancements in mental healthcare delivery. 

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