Getting started: Is telebehavioral health right for your practice?
Telebehavioral health can break down barriers. It connects patients and providers to a wider network, regardless of location, making it easier to match patients with specialists, unique treatments, providers, and patient communities who speak their native language or come from a similar cultural background. Telebehavioral health also offers more privacy than face-to-face care, often making patients more willing to seek behavioral health treatment.
Providing behavioral health services via telehealth takes planning. It requires new ways of delivering care, different workflow and procedures, as well as a new business model. It is important to understand the pros and cons for you and your patients and to decide if providing telebehavioral or telemental health services is right for your practice.
Integrating new telebehavioral services
Decide what telebehavioral services you will provide. Define your current service gaps and the problems you want to solve. Keep in mind that certain behavioral health approaches may not be ideal for telehealth, such as exposure therapy or intensive treatment requiring inpatient monitoring. Some of the most common telebehavioral health services include:
- Psychiatric assessments
- Individual counseling for anxiety and depression
- Treatment related to substance use disorder
- Telepsychiatry for prescription monitoring and refills
Understand the community you serve. Think about what services your patients need and what the common behavioral health challenges are in your area. For example: during COVID-19, health care providers and front line workers are working longer hours in stressful and often dangerous situations. This means an increased need for mental health services for this population.
Research the common behavioral health models that work well with telehealth, including individual therapy, group therapy, and substance use disorder treatment. Decide what approach best matches your skills and what will be most effective in your community. Make a plan to ensure your telebehavioral health services are easily accessible by a diverse range of patients with different needs.
Determine your budget for technology and customer support. Should you use existing telehealth software or hire someone to create a customized behavioral health platform? Review your budget to understand if you have the financial resources to invest in ongoing maintenance and tech support. You may want to bring on a project or telehealth coordinator to help get patients set up with telehealth technology, or an IT specialist to keep your software and internet running smoothly. Get input from existing administrative and facility staff during planning and set up to ensure software and new processes are integrated properly into your existing workflow.
- Take time for staff training. Spend time to make sure your staff has the skills to do their job well. Train staff at all levels on the basics of telehealth as well as addiction and mental health disorders to better understand and support your patients. Include information on cultural sensitivity and accessibility requirements as part of regularly-scheduled skills training.
Exploring telehealth technology
- Get connected. Above all, you will want to make sure your patients can get online for telehealth. Do your research and ensure broadband internet is available, affordable, and easily accessible in the community you plan to serve. Some cities also offer “tele-hubs” — rooms with a computer and free internet access, often located in community centers or libraries.
Understanding telehealth and behavioral health laws
Get familiar with state and local laws. Using telehealth for your behavioral health practice requires following a new set of regulations specific to telehealth. It also means spending more time and cost to stay compliant (video). Review the different laws for telehealth services, including specific state licensure requirements for psychologists and other behavioral health professionals. If you plan to practice telepsychiatry or offer services prescribing controlled substances via telehealth, research the state and federal rules and regulations.
Research telehealth insurance reimbursement. Private insurance companies and even Medicare and Medicaid limit telehealth reimbursement to certain types of services and care. It is important to understand if the services you plan to offer are reimbursable and if the reimbursement rates are enough to cover your costs.
Insurance reimbursements can also take a long time to process. You will need to have enough money set aside to cover your costs until you receive payment for your services.
Many policies have changed to allow for broader telehealth reimbursement during the COVID-19 public health emergency, but these policies may change again, and coverage may end for certain telebehavioral or telemental health services.
More details about incorporating telebehavioral health into your practice:
- Telebehavioral Health Center of Excellence — from the Mid-Atlantic Telehealth Resource Center
- How to start your Telebehavioral health service (video) — from the Northwest Regional Telehealth Resource Center
- Coalition Webinar - Using Telehealth to Support Mental Health During COVID-19 (video) — from the National Consortium of Telehealth Resource Centers
- Telemental Health Best Practices: Do’s and Don’ts to Developing a Thriving Service (video) — from the Northwest Regional Telehealth Resource Center
- Telepsychiatry Essentials (video) — from the National Consortium of Telehealth Resource Centers