Telepsychiatry Trends to Expect in 2019

By Geoffrey Boyce, Originally published on American Journal of Managed Care 

InSight Telepsychiatry is the leading national telepsychiatry service provider organization with a mission to transform access to quality behavioral health care through innovative applications of technology. InSight has 2 decades of experience with telepsychiatry, and serves hundreds of organizations across the country with its on-demand, scheduled, connected services, and Inpathy divisions. InSight is uniquely positioned to offer scalable telepsychiatry services in settings across the continuum of care. InSight has a diverse provider team, a robust internal infrastructure and a history of adapting its programs to fit the needs of a variety of different settings and populations.
The upward growth trajectory and expanded reach of telepsychiatry models remain strong. As telemedicine continues to open new doors to access in healthcare, a bird’s eye view of current trends suggests that behavioral health is the healthcare sector that has experienced the most positive impact. The telepsychiatry market is beginning to mature and industry leaders are emerging and continuously raising the bar.Telepsychiatry plays a crucial role in not only improving the outlook on severe psychiatric professional shortages, but also in aligning with consumer expectations and the evolving demands of value-based care. As healthcare closes the book on 2018, here are trends and changes the industry can expect to see on the telepsychiatry front in 2019.

New Policies Expand the Reach of Telepsychiatry for Opioid Use Disorder   
Telepsychiatry has the potential to help address one of the nation’s most significant crises: opioid use disorder. However, policy changes are needed first. In 2019, the Drug Enforcement Administration (DEA) is expected to establish special registration for telemedicine, as required by the SUPPORT for Patients and Communities Act of 2018.

The prescribing of controlled substances is necessary for a common treatment of opioid use disorder: medication assisted treatment (MAT). However, current federal regulation—the Ryan Haight Online Pharmacy Consumer Protection Act of 2008—limits the prescribing of controlled substances via telemedicine. By creating the long-awaited special registration for telemedicine in 2019, the DEA will help open doors for the appropriate prescribing of controlled substances via telemedicine, and thus allow for telepsychiatry to help address the opioid epidemic.

Additionally, another impactful way the special registration for telemedicine would improve access to needed care is with child and adolescent psychiatry—a discipline where certain controlled substances are the preferred treatment for common disorders such as attention deficit/hyperactivity disorder.

New Policies Expand the Reach of Telepsychiatry for Medicare Populations    
Another exciting policy development for telemental health is the Mental Health Telemedicine Expansion Act that was introduced this year, which, if enacted in 2019, would have a significant impact on America’s aging population. The bill would eliminate the originating site requirement for Medicare reimbursement for telemental health services. Currently, there are 8 originating site requirements for Medicare reimbursement, including provider offices, hospitals, critical access hospitals, rural health clinics, federally qualified health centers, skilled nursing facilities, community mental health centers, and hospital-based or critical access hospital-based renal dialysis centers. By eliminating this requirement, Medicare beneficiaries would be able to be reimbursed for telemental health services they receive in their home and other settings.

Growth of Telepsychiatry in Collaborative Care Models
In recent years, the use of team-based approaches like the IMPACT model have proven successful for a wide range of behavioral health conditions. Telepsychiatry helps advance the use of these models by removing the need for care teams to colocate. Providers can conveniently interact and seamlessly deliver care via televideo.

Payers are particularly invested in the expanded use of collaborative care models and are increasingly looking for creative ways to partner with telepsychiatry providers or practices leveraging telepsychiatry to achieve the greatest value in care. With the recent addition of collaborative care codes for reimbursement, providers will also be encouraged to incorporate more team-based treatments into care.

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