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In-Person or Virtual: Behavioral Health Patients Often Not Given Choice
Many behavioral healthcare patients are not presented with choices of whether to receive in-person or telehealth-based care, according to a study released by RAND Corporation on Tuesday, and researchers say the lack of options could be negatively impacting patient satisfaction and rapport with clinicians.
Findings from the study, which was published in the journal Health Affairs, are based on a nationally representative survey of more than 2000 US adults, 571 of whom who used behavioral healthcare services within the past year. An additional 26 adults with bipolar disorder or depression were interviewed in February and March.
The survey produced the following findings:
- About one-third of patients who are receiving therapy or medication visits said their clinician does not offer both telehealth and in-person treatment options.
- 32% of respondents said they did not receive their preferred modality.
- 45% said they do not believe their clinician considered their modality preference when determining their visit type.
“These findings suggest that patients' modality preferences need to be a greater consideration in both clinical discussions and policy decisions,” study lead author Jessica Sousa, senior policy analyst at RAND, said in a news release. “Expanding telehealth increases access to care, but telehealth alone might not be sufficient. Ideally, patients should have access to some amount of in-person care, given that many prefer it or may need it.”
About 22% of therapy recipients surveyed said their clinician offered only a telehealth option, while 9% reported their clinicians offering in-person visits only. Among those receiving medication, those rates flipped, with 20% only having access to in-person care and 13% reporting clinicians offering services via telehealth exclusively.
While many patients who were interviewed expressed a preference for in-person care, noting that they felt it provided a more personal experience and helped to build rapport, a majority of patients still said they wanted clinicians to offer both in-person and remote options. Rarely did clinicians ask patients about their modality preferences, according to interviewees.
“The focus of telehealth policy in recent years has been on increasing access to telehealth services,” Sousa said. “Although generous payment policies may encourage clinicians to offer telehealth, they may also inadvertently lead to cannibalization of in-person care.”
To that end, Sousa added, it is critical for providers to implement telehealth options in a way that expands—rather than contracts—treatment access and options for patients.
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