The NCSL Blog


By Sydne Enlund

Did you know that 113 million Americans lack access to appropriate mental health services? In fact, as of November 2019, 61% of mental health professional shortage areas—a designation that indicates health care provider shortages—are in rural areas.

TelehealthToday is National Rural Health Day, which brings attention to the unique health care challenges facing rural areas and showcases efforts to address those challenges. Rural communities face challenges in accessing health care services, as residents are more likely to be uninsured, live within a health professional shortage area and experience a local hospital closure.

As state spending on health care continues to increase, policymakers look for cost-effective solutions to ensure access to health care, including behavioral health, for their constituents. Policymakers increasingly consider telehealth to provide health care remotely using technology. Telehealth increases access to health care providers, including behavioral health providers, for rural residents and enables them to receive care in their own community.

Many behavioral health providers use telehealth services to increase access to necessary mental health care. This is especially important for individuals who experience additional barriers when obtaining care in certain settings. Rural communities use telehealth to provide a variety of behavioral and mental health services, including case consultations from psychologists, peer support specialists or addiction counselors, treatment options such as counseling or medication-assisted treatment and more. State actions to increase access to these services include improving rural broadband, reimbursement for telehealth services and licensing.

The federal SUPPORT for Patients and Communities Act expands telehealth access for patients with substance use disorders (SUDs). The law removes the geographic restrictions in Medicare for telehealth services for treating an individual with an SUD diagnosis.

State leaders may wish to explore strategies to expand the use of telehealth more broadly in their communities. Every state provides Medicaid reimbursement for some type of telehealth service. At least 39 states and Washington, D.C., have private payer policies, which may require private insurance plans to cover or pay for telehealth services.

Telehealth has the potential to help states leverage a shrinking and maldistributed health care workforce, increase access to health care services and lower health care costs. NCSL’s brief on Increasing Access to Health Care Through Telehealth provides more information on the current landscape of telehealth policy, including coverage and reimbursement, licensure and provider practice standards.

Happy National Rural Health Day!

Sydne Enlund is a policy specialist in NCSL's Health Program.

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About the NCSL Blog

This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.