Skip to main content
Sister Publication Links
  • ESG: THE NEW IMPERATIVE
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Digital Health
  • Insights
    • ACA 10 Years After
    • Best Practices
    • Special Reports
    • Innovations
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Supply Chain
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • MORE +
    • Contact Us
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Technology
April 06, 2022 03:46 PM

Rural veterans have fewer ED visits, more psychotherapy with VA tablets

Lisa Gillespie
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    GettyImages-634474095_i_older person on ipad_telehealth_i.jpg
    Getty Images

    Rural veterans who received tablets from the Department of Veterans Affairs had more telehealth psychotherapy appointments and fewer suicide-related emergency department visits, according to a new study published Wednesday.

    Study authors from the VA Health Economics Resource Center located at the VA Palo Alto Health Care System in California tracked more than 13,000 veterans with a mental health history over the first year of the pandemic, after receiving a broadband- and video-enabled tablet from the VA. The tablets enabled veterans to receive more mental healthcare than they normally would have, and they had a lower likelihood of having an emergency department visit for any reason, according to the study.

    Researchers concluded that other health systems could undertake similar projects for their rural patients to increase access to mental healthcare and prevent suicides.

    "The findings seem really promising for reducing the rural disparity in suicide, which is growing as we're seeing higher and higher rates of suicide in rural areas," said Kimberly Smathers, managing director at ATI Advisory.

    She added that using tablets at hoe may help older adults living in rural areas erase the stigma around suicide and mental health.

    There are higher rates of suicide among people living in rural areas than urban areas, and that gap has only increased since 1999, according to the Centers for Disease Control and Prevention. U.S. veterans' rate of suicide is almost twice as high as people who haven't served in the military. Rural veterans are more likely to die by suicide than veterans living in urban areas.

    The VA's Office of Rural Health and Office of Connected Care in 2016 started distributing tablets to veterans. As of September 2021, more than 100,000 veterans had tablets, with 93% of those distributed during the pandemic. One-third of veterans who received the electronic devices live in rural areas, and researchers used data from the health system to track outcomes those rural residents with a previous mental health visit.

    Related Articles
    Payer-provider partnerships can play key role in suicide prevention
    U.S. suicides dropped last year, defying pandemic expectations

    Tablets were associated with an overall 20% reduction in the likelihood of an ED visit, a 36% reduction in the likelihood of suicide-related ED visit and an increase of 3.5 video psychotherapy visits per year.

    Though the findings offer a potential template for non-VA health systems and payers, the VA system has a dramatically different integrated structure. For instance, most U.S. insurers operate business units in silos, where mental healthcare and medical care operate separately.

    "They [insurers] certainly should be interested in this finding, but one difficulty companies often have are separate budgets and management systems for inpatient and outpatient," said Dr. Joe Parks, medical director at the National Council for Mental Wellbeing. "There's a number of interventions that show treating mental illness reduces medical hospitalization, but if those costs are to behavioral health, and all the savings go to medical, it's not sustainable."

    Download Modern Healthcare’s app to stay informed when industry news breaks.

    Many insurers have tried pilot projects similar to the VA's program, but they face issues with grant funding and extending the initiatives, Parks said.

    "Grant-funded pilots usually show good results but very commonly never result in permanent change to the system of care," Parks said. "They die once the grant funding runs out because there's no volume across all payers to keep it going."

    Scan Health Plan, a not-for-profit insurer with 275,000 members mostly in Medicare Advantage, launched a project shortly before the pandemic started to target mental healthcare access. The plan worked with a physician group in California in a region with a shortage of mental health clinicians. Plan members, but also any older patient of the practice, gained access to psychiatrist via video that was set up in a primary care office, all funded by Scan. Once the pandemic hit, in-office telehealth visits shifted to patient homes.

    The plan stopped funding the program after 18 months, but because of results in lower depression and anxiety measure scores and other results, the physician group decided to continue the program and scale it to all patients. Scan Health Chief Medical Officer Dr. Romilla Batra said they discontinued funding because it operates value-based care pay arrangements where the physician group was already being paid to deliver mental healthcare.

    "We knew that physicians perhaps were not ready to try and test new things, but we knew there was a need for it [mental health service innovation]," Batra said. "We are always thinking about how we can bring care to members, but also in partnership with the primary care physician so it's [care delivery] not disjointed."

    Scan is currently working with UCLA to evaluate the program and will soon publish findings on improvements in depression scores and impacts to hospitalizations or suicide-related emergency department visits.

    Community behavioral health centers receive higher Medicare reimbursement in exchange for coordinating patients' medical care by making formal relationships with area hospitals and primary care physicians, according to Parks. Many centers transitioned to telehealth because of the pandemic.

    Non-VA providers got a boost to expand telehealth when the Department of Health and Human Services broadened telehealth payment under the COVID-19 public health emergency in 2020. The Biden administration is expected to extend the current deadline past April 16, but there is a question of how long it will continue as COVID-19 cases subside. While Congress recently put in place a five-month extension for telehealth payments past emergency expiration, it will have to pass legislation to keep the changes permanent.

    Mei Kwong, executive director at the federally designated national telehealth policy research group the Center for Connected Health Policy, said private payers have flexibility to make these payments permanent, but many also follow Medicare's lead of Medicare policy.

    "Providers should have the option of utilizing it [telehealth] if they think it's appropriate for that specific patient at that specific time," Kwong said.

    Related Article
    Becerra: HHS will fight for more telehealth after public health emergency ends
    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    money arrows decrease down 2.png
    Changing employer market leaves digital health companies rethinking strategy
    Two pill bottles from Amazon Pharmacy
    Amazon rolls out generic drug subscription service
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Health IT Strategist (HITS) Newsletter: Sign up for the latest IT and medical technology news delivered 3 days a week (M, W, F).
     
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Digital Health
    • Insights
      • ACA 10 Years After
      • Best Practices
      • Special Reports
      • Innovations
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Supply Chain
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • MORE +
      • Contact Us
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing