U.S. Telehealth Regulations Changing the Landscape in 2023

Our mental health is inseparable from our physical health and well-being. Yet, unlike for physical health conditions, treatment for mental health conditions has long been underfunded, underappreciated, and overly stigmatized.

While the COVID-19 pandemic certainly intensified the unmet needs for mental health services and made it more difficult for individuals to access mental health care services, this issue significantly predates and outscales the onset of the pandemic in early 2020.

According to a recent poll conducted by the Kaiser Family Foundation and CNN, approximately 90 percent of Americans believe there is a mental health crisis in the United States today. An estimated 1 in 5 adults are affected by mental illness, and of those nearly half do not receive the treatment they need.

In 2022, reports of a 25 percent increase in the global prevalence of anxiety and depression pushed the Biden administration to prioritize access to mental health services, including the $1.5 trillion Consolidated Appropriations Act of 2022 that extended Medicare coverage related to telehealth practices.

Among the various barriers cited by KFF/CNN poll respondents, an insufficient supply of mental health providers was cited as one of the more significant contributing factors. In 2021, more than one-third of Americans (37 percent) lived in geographic areas with shortages of mental health professionals.

Lending support to the mental health crisis are the many different companies delivering telehealth services. Experts have predicted that certain areas in health care, including mental health, have been riper for disruption by telehealth companies.

A July 2021 report published by McKinsey & Company predicted that psychiatry has the highest penetration for telehealth usage, at 50 percent. A March 2022 study from the Kaiser Family Foundation reported that during the peak of the pandemic in March through August 2020, approximately 40 percent of mental health visits were performed via telehealth (compared to 11 percent of non–mental health visits).

And, while non–mental health visits performed via telehealth have more recently dropped to 5 percent, mental health visits performed via telehealth have continued to hold strong at 36 percent. Although a common perception is that reaching out for and receiving mental health care services carries a high degree of stigma, the access being provided by digital platforms has helped patients receive care discreetly and under circumstances where they feel comfortable.

As a result, stakeholders have worked to expand access to mental health care services through regulatory changes. The need for putting social distancing measures in place during the pandemic contributed to a sharp increase in the provision of telehealth services, as states promoted changes in regulations that served to widen access of counseling, therapy, prescribing, and other services via remote methods such as video and telephone.