Table 2. Adjusted Odds of Telehealth Availability at Mental Health Treatment Facilitiesa.
| Measure | Payment parity | Audio-only authorization | IMLC | PSYPACT | ||||
|---|---|---|---|---|---|---|---|---|
| AOR (95% CI) | P value | AOR (95% CI) | P value | AOR (95% CI) | P value | AOR (95% CI) | P value | |
| State level | ||||||||
| Policy ratification | 1.11 (1.03-1.19) | <.001 | 1.73 (1.64-1.81) | <.001 | 1.40 (1.24-1.59) | <.001 | 1.21 (1.12-1.31) | <.001 |
| Medicaid expansion | 0.66 (0.37-1.20) | .17 | 0.67 (0.38-1.19) | .17 | 0.67 (0.37-1.21) | .19 | 0.68 (0.37-1.23) | .20 |
| County-level characteristics | ||||||||
| Ruralb | 1.67 (1.48-1.88) | <.001 | 1.68 (1.49-1.89) | <.001 | 1.67 (1.48-1.88) | <.001 | 1.67 (1.48-1.88) | <.001 |
| % of Black residents | ||||||||
| ≤5 | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| >5-10 | 0.87 (0.78-0.97) | .01 | 0.87 (0.77-0.97) | .01 | 0.87 (0.78-0.97) | .01 | 0.87 (0.78-0.97) | .01 |
| >10-20 | 0.78 (0.69-0.89) | <.001 | 0.78 (0.68-0.80) | <.001 | 0.78 (0.69-0.89) | <.001 | 0.78 (0.69-0.89) | <.001 |
| >20 | 0.58 (0.50-0.68) | <.001 | 0.58 (0.50-0.67) | <.001 | 0.58 (0.50-0.68) | <.001 | 0.58 (0.50-0.68) | <.001 |
| % of Hispanic residents | ||||||||
| ≤5 | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| >5-10 | 0.92 (0.82-1.03) | .14 | 0.92 (0.82-1.03) | .14 | 0.92 (0.82-1.03) | .14 | 0.92 (0.82-1.03) | .14 |
| >10-20 | 0.91 (0.79-1.04) | .18 | 0.91 (0.79-1.04) | .17 | 0.91 (0.79-1.04) | .18 | 0.91 (0.79-1.04) | .18 |
| >20 | 0.86 (0.73-1.01) | .07 | 0.86 (0.73-1.01) | .06 | 0.86 (0.73-1.01) | .07 | 0.86 (0.73-1.01) | .07 |
| % of Residents aged 0-17 y | ||||||||
| ≤25 | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| >25 | 1.16 (1.00-1.34) | .05 | 1.16 (1.00-1.35) | .05 | 1.16 (1.00-1.34) | .05 | 1.16 (1.00-1.34) | .05 |
| % of Residents aged ≥65 y | ||||||||
| ≤15 | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| >15 | 0.90 (0.83-1.02) | .10 | 0.90 (0.83-1.02) | .10 | 0.92 (0.83-1.02) | .10 | 0.92 (0.83-1.02) | .10 |
| % of Residents participating in public assistance programs | ||||||||
| ≤10 | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| >10 | 1.11 (1.01-1.21) | .03 | 1.11 (1.01-1.22) | .03 | 1.11 (1.01-1.21) | .03 | 1.11 (1.01-1.21) | .03 |
| % of Households without internet access | ||||||||
| ≤15 | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| >15 | 1.16 (1.05-1.30) | .01 | 1.17 (1.05-1.30) | .01 | 1.17 (1.05-1.30) | .01 | 1.17 (1.05-1.30) | .01 |
| Facility-level characteristics | ||||||||
| Accepted Medicaid | 0.75 (0.65-0.86) | <.001 | 0.75 (0.65-0.86) | <.001 | 0.75 (0.65-0.86) | <.001 | 0.75 (0.65-0.86) | <.001 |
| CMHC | 1.40 (1.28-1.53) | <.001 | 1.40 (1.27-1.53) | <.001 | 1.40 (1.28-1.53) | <.001 | 1.40 (1.28-1.53) | <.001 |
Abbreviations: AOR, adjusted odds ratio; CMHC, community mental health center; IMLC, Interstate Medical Licensure Compact; NA, not applicable; PSYPACT, Psychology Interjurisdictional Compact.
a
All regression models included state and year fixed effects. The SEs were clustered at the facility level.
b
Reference group: urban.