Identifying Factors Associated With Variation in Telemental Health Delivery at Federally Qualified Health Centers

Area of Science:

• Health Services Research
• Telehealth
• Mental Health Services

Background:

• COVID-19 accelerated telemental health adoption in federally qualified health centers (FQHCs).
• Factors influencing telemental health delivery in FQHCs remain unclear.
• This study examines telemental health delivery by clinician type and workforce composition in U.S. FQHCs.

Purpose of the Study:

• To characterize telemental health service delivery proportions in FQHCs.
• To identify factors associated with telemental health delivery.
• To understand the relationship between workforce composition and telemental health utilization.

Main Methods:

• Utilized 2021 Uniform Data System data from 1,270 HRSA-funded FQHCs.
• Characterized telemental health proportion by state and clinician type.
• Conducted multivariate beta regression analyses adjusting for center size, patient mix, and state.

Main Results:

• FQHCs delivered 43% of mental health visits via telemental health in 2021, varying significantly by state and clinician.
• Telemental health proportion was higher for psychiatrists (61%) than psychologists (49%) and social workers (45%).
• Increased psychiatrist supply, grant dollars per patient, and Asian patient proportion were associated with higher telemental health delivery.

Conclusions:

• Telemental health access varies by state and FQHC workforce composition.
• Workforce and funding strategies are needed to enhance telemental health availability.
• Further research should explore optimal strategies for increasing telemental health services.