TABLE 1.
Distribution of Outpatient Mental Health Treatment Facilities Offering Telehealth Services
| Telehealth Services Available (Unadjusted) | Telehealth Services Available (Adjusted) | ||||
|---|---|---|---|---|---|
| Characteristic | Mental Health Facilities | n (%) | P | % | P |
| The entire United States | 8860 | 3848 (43.4) | NA | NA | NA |
| US Region | |||||
| Northeast | 1889 | 397 (21.0) | Reference | 26.8 | Reference |
| Midwest | 2326 | 998 (42.9) | <0.001 | 40.6 | <0.001 |
| South | 2602 | 1447 (55.6) | <0.001 | 53.7 | <0.001 |
| West | 2043 | 2043 (49.2) | <0.001 | 47.8 | <0.001 |
| Metropolitan location | |||||
| Metropolitan | 6745 | 2517 (37.3) | Reference | 40.3 | Reference |
| Not metropolitan | 2115 | 1331 (62.9) | <0.001 | 53.2 | <0.001 |
| Form of payment | |||||
| Does not accept Medicaid | 936 | 500 (53.4) | Reference | 54.0 | Reference |
| Accepts Medicaid | 7924 | 3348 (42.3) | <0.001 | 42.1 | <0.001 |
| Patient population | |||||
| Serves children (no age limit or 10+) | 6617 | 2971 (44.9) | Reference | 45.2 | Reference |
| Serves adults only (17+) | 2243 | 877 (39.1) | <0.001 | 38.2 | <0.001 |
| Facility ownership | |||||
| Public sector | 1648 | 1028 (62.4) | Reference | 59.4 | Reference |
| Private for profit organization | 1790 | 655 (36.6) | <0.001 | 36.2 | <0.001 |
| Private nonprofit organization | 5422 | 2165 (39.9) | <0.001 | 41.0 | <0.001 |
| Community Mental Health Center | |||||
| No | 6452 | 2499 (38.7) | Reference | 41.2 | Reference |
| Yes | 2408 | 1349 (56.0) | <0.001 | 49.3 | <0.001 |
| Shelter-in-place law | |||||
| No state or local law | 426 | 257 (60.3) | Reference | 51.7 | Reference |
| Full state law | 8105 | 3409 (42.1) | <0.001 | 42.8 | 0.024 |
| Local not state law | 329 | 182 (55.3) | 0.167 | 48.3 | 0.575 |
| American Telemedicine Association Grade for State (2016) | |||||
| Grade A | 1044 | 535 (51.2) | Reference | 40.0 | Reference |
| Grade B | 6289 | 2694 (42.8) | <0.001 | 44.6 | 0.266 |
| Grade C | 1527 | 619 (40.5) | <0.001 | 40.9 | 0.845 |
| Telemedicine Parity Law (2016) | |||||
| No | 3623 | 1451 (40.0) | Reference | 42.9 | Reference |
| Yes | 5237 | 2397 (45.8) | <0.001 | 43.8 | 0.698 |
| COVID-19 cases | |||||
| First quartile (lowest) | 728 | 472 (64.8) | Reference | 52.2 | Reference |
| Second quartile | 1352 | 772 (57.1) | <0.001 | 49.8 | 0.296 |
| Third quartile | 2407 | 1120 (46.5) | <0.001 | 44.6 | 0.015 |
| Fourth quartile (highest) | 4373 | 1484 (33.9) | <0.001 | 39.1 | <0.001 |
The American Telemedicine Association grades are from the organization’s categorization of state telehealth policies based on 13 indicators that are related to coverage and reimbursement for telehealth services. More details on how the measures are created can be found here: https://mtelehealth.com/state-telemedicine-gaps-analysis-coverage-reimbursement/. The number of COVID-19 cases adjusted for population size comes from the USAFacts. After estimating the logistic regression, predictive margins were used to generate adjusted probabilities. Standard errors in the multivariable regression were clustered at the state level.