Data, Training Key to Keeping Telebehavioral Flexibilities in Place Post-COVID-19

The ability to get paid for virtual services has been a game changer for behavioral health providers amid the pandemic. It’s allowed them to continue providing services and remain afloat financially over the past year and a half — and many stakeholders believe telebehavioral health has the power to improve patient access and providers’ bottom lines even post-pandemic.

However, as the world starts to slowly return to normal, the future of telebehavioral health remains in flux. It’s still unclear which COVID-19-related state, federal and payer telehealth flexibilities will remain in place.

But providers have a critical role to play in determining that fate, according to Bragg Hemme, a shareholder and health care attorney at the national law firm Polsinelli.

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“If we’re going to make any change in how this is operated long-term, we’re going to have to be able to back it up with that data,” she said. “As we move to different payment models like value-based care and population health management, we’ll also need that data — because it’s just the only way to be able to manage that care and … protect patients and providers.”

Hemme made those comments during a recent Behavioral Health Business webinar on virtual care’s place in the future of behavioral health. She said she’s currently working with state and federal governments in an effort to make some COVID-19-era telehealth flexibilities permanent for behavioral health providers, whom she often represents.

“Being able to back [anecdotal successes] up with data is how we’re going to convince payers and regulators that the licensure model or the payment model that we would like to develop, or that has been created as an outgrowth of COVID, … makes sense,” she said.

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For providers like Ginger and the Hazelden Betty Ford Foundation, demonstrating the success of virtual care services is no problem: Both organizations have been tracking various virtual care measures since well before the pandemic.

While Ginger’s model has always been virtual, Hazelden Betty Ford launched a pilot version of its continuum of virtual offerings, known as RecoveryGo, back in March 2019. Today, its virtual SUD treatment offering is available in about half of the states across the country, and the organization has plans to expand that model into all 50 states in the months to come

Bob Poznanovich — vice president of business development at Hazelden Betty Ford and a panelist on BHB’s recent webinar — said research and feedback have been key to the SUD nonprofit’s successful rollout of RecoveryGo.

He said the organization — which has 17 locations and counting, in addition to the virtual offering and a slew of other business arms — has research scientists who study virtual care patients. Additionally, Hazelden Betty Ford does feedback groups, satisfaction surveys, engagement polls and effectiveness measurements for patients and staff.

Ginger also tracks a large swath of outcome and satisfaction measures. While those data points are highly important, so is staff training and tracking, according to Dana Udall, chief clinical officer at Ginger.

“For many mental health providers who transition to doing telehealth, managing risk, for example, is a pretty daunting task,” said Udall, who was also a panelist on the BHB webinar. “We do a lot of training on that at Ginger, and we have a lot of policies, procedures and protocols in place.” 

Based in San Francisco, Ginger provides on-demand virtual behavioral health care services such as coaching, therapy and psychiatry visits, which clinicians deliver to members via text or video.

Udall said she expects the future of virtual behavioral health to include and allow for increased integration with primary care and physical health providers, as well as more specificity within telebehavioral care.

Meanwhile, Poznanovich is predicting at least some of the COVID-19-related telehealth flexibilities to stick post-pandemic.

“It’s out of the box now, it’s going to be hard to put back in the box … even with the emergency declarations being removed,” Poznanovich said. “We have to get more regulations and make some common sense out of the nonsense that exists on the geographic distribution of patients. … I think you’ll see pressures to make it easier for patients to get care wherever they’re at.”

Hemme said she hopes to see provider organizations lobby together to make it happen.

“I think there’s a good opportunity to use the data that’s already been collected in order to make positive change,” she said.

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