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Higher Cost of Telehealth Raises Concerns for Future of the Beneficial Treatment Option
(Part 3 of 3)
The higher cost of telehealth, compared to in-person treatment, raises concerns that health insurance companies reducing compensation may impact the ability to utilize the treatment, says Mark Zimmerman, MD, Rhode Island Hospital, Providence. In this video, Dr. Zimmerman discusses the future of telehealth treatment at his program and beyond post COVID-19 pandemic.
In the previous Part 1 and Part 2 in this series, Dr. Zimmerman discussed the impetus for his study that found telehealth partial hospital treatment was as effective as in-person treatment and the study’s practical implications for clinicians.
Read the transcript:
Will we continue with a telehealth delivery of partial hospital level of care when, finally, the pandemic has sufficiently resolved so that we can go back to in-person care? We hope to.
In fact, the decision probably will not be ours. It really will be determined, in large part, by insurance company reimbursement. Our concern is that there will be a reduction in reimbursement, despite the fact that we find it actually more costly to deliver care virtually.
It's more costly in terms of the demand on staff. Having to do pretreatment meetings with patients to acclimate them to Zoom and acclimate them to the program has placed a burden on support staff time.
We also, when providing the group therapy, not only have one of the therapists leading the group, and we usually have multiple groups running at the same time. We have another therapist who oversees all of the groups in case patients are triggered, need to step out of group, and are feeling emotionally overwhelmed.
When we're in-person, there are a number of treaters around who can address whatever needs the patient has, but in the virtual program, we felt it important to have someone always available to speak with a patient if they were feeling emotionally destabilized.
It's actually been more costly to deliver treatment in the virtual format, and thus remain concerned that there will actually be a reduction in compensation from insurance companies.
Lastly, not only the greater availability of care provided to patients who might otherwise, might not be able to come for in-person treatment, the fact that virtual treatment is as effective as in-person treatment may well allow us and others to provide care in a geographically larger region.
Programs like ours that have specialists and expertise in treating individuals with trauma, post-traumatic stress disorder, borderline personality disorder, could then make these services available to areas where there are no specialists or individuals or programs that have that level of expertise.
Hopefully, telemedicine delivery in partial hospital, as well as outpatient level of care, will become an appropriately compensated and a regular component of the delivery of behavioral healthcare.
I thank you very much for your attention. If anybody has any questions, please feel free to email me at mzimmerman@lifespan.org. Thank you.
Reference
Mark Zimmerman, MD, received his medical degree from Chicago Medical School, North Chicago, Illinois, and completed his postgraduate training at the Medical College of Pennsylvania/Eastern Pennsylvania Psychiatric Institute, Philadelphia, PA. Currently, he is a professor of psychiatry and human behavior at Brown University in the Department of Psychiatry and Human Behavior. Dr. Zimmerman is also the director of both Outpatient Psychiatric Services and Partial Hospital Services at Rhode Island Hospital, Providence, Rhode Island.
Dr. Zimmerman is the author of more than 300 articles and serves on the editorial board of 10 journals including the Journal of Affective Disorders and the Journal of Psychiatric Research.