Telehealth Use and Access to Care for Underserved Populations Before and During the COVID-19 Pandemic

While several studies have documented the rapid growth in telehealth visits during the pandemic, none have examined its relationship with greater overall access to care among vulnerable populations. We use Association of American Medical Colleges' Consumer Survey data to examine the relationship between access to care and telehealth use before and during the pandemic. The proportion of survey respondents who were always able to get medical care when needed was slightly lower in 2020 compared with prior years while telehealth use rose dramatically. Disparities in telehealth use for Medicaid beneficiaries and rural respondents disappeared during the pandemic, but remained for lower-income populations. Before the pandemic, telehealth use was associated with greater access, but not during the pandemic—when it appears to have become a substitute for in-person. After the pandemic, telehealth could once again be an opportunity to supplement access to care, if telehealth policies enacted during the pandemic are made permanent.

Caring for children in foster and kinship care during a pandemic: lessons learned and recommendations

Through qualitative feedback from professionals in healthcare, mental health, and child welfare, this study explored the impact of the COVID-19 pandemic on the health and well-being of children in the child welfare system. Positive outcomes and challenges related to the care of children in foster or kinship care in Texas during the COVID-19 pandemic are described. Themes identified included disparities in the child welfare system;utilization of telehealth;cross-sector communication and collaboration;safety considerations;and placement stability and support. The article concludes with recommendations in each of these areas for ensuring the health and well-being of children in foster and kinship care during a pandemic.

In‐person MH service decline during pandemic offset by telehealth increases

Although the pandemic disrupted in‐person mental health care, that disruption was counteracted by a rapid expansion of telehealth service use by adults with such disorders as depression, anxiety and post‐traumatic stress disorder, according to new research by the RAND Corporation.

Expanded access to OUD medication during pandemic proved beneficial

Several federal agencies in 2020 relaxed restrictions on medication treatments for opioid use disorder (OUD) to ensure continued access to treatment during the COVID‐19 pandemic. In order to examine the long‐term impacts of these measures, investigators conducted a longitudinal cohort study using Medicare data to compare use of OUD‐related telehealth services, use of medications to treat OUD, and incidence of overdose requiring medical treatment before and during the pandemic. Several Centers for Medicare & Medicaid Services data sources documenting behavioral health disorders and use of related treatment services were accessed. The cohort consisted of adult Medicare fee‐for‐service beneficiaries. Two mutually exclusive groups of individuals initiating OUD treatment before and after the pandemic were identified. The groups were followed for 6 months after their 6‐month index treatment periods in order to evaluate retention in OUD treatment. The primary outcomes were receipt of telehealth services, receipt of medication for OUD, and medically treated overdose. More individuals in the pandemic group compared with the pre‐pandemic group received telehealth services, with 19.6% of the pandemic group and 0.6% of the pre‐pandemic group receiving telehealth care related to OUD. Receipt of any medication for OUD was more prevalent in the pandemic group (7.5% vs. 4.4%). The percentages of patients receiving buprenorphine or medications from an opioid treatment program were higher in the pandemic cohort. Rates of medically treated overdose were similar in the two groups. Within the pandemic cohort, receipt of telehealth services was associated with increased retention in medication treatment. Those receiving OUD‐related telehealth services were also less likely to experience a medically treated overdose. The researchers suggested that future studies should examine the effect of telehealth availability on other outcomes, such as illicit opioid use and overdose deaths. [Jones C, et al. JAMA Psychiatry 2022;published online Aug 31;doi: 10.1001/jamapsychiatry.2022.2284]