Telehealth has emerged as a critical avenue for addressing substance use disorder treatment (SUDT) needs. By bridging gaps in access to care, it has shown promise, particularly for those living in rural areas. However, a recent study highlights concerning disparities in how telehealth is utilised across different groups, particularly among Medicaid-covered individuals.

Growing Access to Telehealth Services

Between 2019 and 2023, telehealth services for SUDT grew significantly. The study revealed the average monthly telehealth services increased from 44.6 to 10,974.3 across insured adults. While this surge demonstrates an increased reliance on telehealth, in-person SUDT services only saw a modest rise during the same period.

For individuals in rural areas, the benefits of telehealth were evident. Overall SUDT services among rural populations surged by 89.9%, compared to a 48.7% increase in urban areas. This growth suggests telehealth can support care delivery in remote locations where access to in-person treatment is limited due to transportation challenges and workforce shortages.

Unequal Utilisation Among Populations

One of the most concerning findings relates to disparities among Medicaid-covered individuals. Despite an overall increase in telehealth SUDT utilisation, Medicaid-covered individuals were underrepresented, making up 75% of telehealth SUDT but 93.2% of overall SUDT services. This stands in contrast to Medicare Advantage and commercially insured individuals, who were overrepresented in telehealth SUDT usage.

According to research published in JAMA Network Open, “Medicaid-covered individuals were underrepresented within telehealth SUDT utilisation, with overall SUDT declining. This finding raises equity concerns for Medicaid populations.” (source)

This discrepancy highlights potential challenges in accessing telehealth services for underserved populations. It raises critical questions about whether telehealth is truly addressing the gaps for vulnerable groups or whether barriers like technology access continue to exist.

Telehealth’s Promise for Rural Communities

For rural individuals, telehealth appears to be playing a vital role in improving access to SUDT. With fewer physical treatment facilities available, telehealth’s rapid growth has the potential to level the playing field in accessing care. However, as this study revealed, efforts must ensure telehealth’s benefits extend to all groups equally.

While telehealth has brought benefits, researchers have noted its limitations. A study in Health & Place observes, “Telehealth extends access to treatment for opioid use disorder (OUD), but it also creates new care inequities within and between providers and clientele that can undermine effective care and recovery.” (source)

Equitable Access to Telehealth for SUD

The findings underscore the need for policies that ensure telehealth access across all demographics. It is essential to eliminate barriers, such as a lack of technology or limited internet connectivity, that disproportionately affect certain groups. Telehealth for substance use disorder has the potential to address gaps in treatment, but only if it is accessible to everyone.

Source: JAMA Network