A study from Included Health and Harvard Medical School found that people with high-deductible health plans were less likely to use telemental health services when they had to pay out-of-pocket.
The study looked at patients across the U.S. who received telemental healthcare through Included Health. One group started charging for telehealth visits halfway through the study period, while the other group didn’t charge at all during the same time frame.
Following the reintroduction of cost sharing, there was a noticeable reduction in the average number of telemental health visits per patient per month in the intervention group compared to the control group.
Many patients faced with out-of-pocket costs either reduced their visits or discontinued seeing their mental health specialists altogether. The study’s authors suggest that such findings underscore the potential adverse impact of reinstating cost sharing on mental health service utilization and subsequent clinical outcomes.
The COVID-19 pandemic prompted a significant increase in telehealth visits, particularly for mental health services, facilitated by regulatory exemptions such as waiving telehealth visits from deductibles in high-deductible health plans.
This exemption, extended through the end of 2024, has been crucial in maintaining access to care. However, debate continues regarding its permanent implementation, with research consistently indicating that patient cost sharing diminishes both high- and low-value healthcare utilization.
Given ongoing concerns about access to mental health treatment, the study advocates for policies that reduce cost sharing for both in-person and telemental health visits to help patients remain in treatment.
The authors refrain from issuing specific policy recommendations but emphasize the importance of addressing barriers to care access, especially in the context of mental health services.
In a broader legislative context, recent initiatives like the Preserving Telehealth, Hospital, and Ambulance Access Act aim to sustain telehealth flexibilities introduced during the pandemic.
These efforts highlight the evolving landscape of healthcare delivery and the need to balance regulatory frameworks to support continued telehealth utilization, particularly for vulnerable populations and rural communities reliant on such services.
