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Health Aff (Millwood). 2018 Dec;37(12):1940-1947. doi: 10.1377/hlthaff.2018.05134.

How Is Telemedicine Being Used In Opioid And Other Substance Use Disorder Treatment?

Author information

1
Haiden A. Huskamp ( huskamp@hcp.med.harvard.edu ) is the 30th Anniversary Professor of Health Care Policy, Department of Health Care Policy, Harvard Medical School, in Boston, Massachusetts.
2
Alisa B. Busch is an associate professor of psychiatry and health care policy, McLean Hospital and the Department of Health Care Policy, Harvard Medical School.
3
Jeffrey Souza is a biostatistician in the Department of Health Care Policy, Harvard Medical School.
4
Lori Uscher-Pines is an associate policy researcher at the RAND Corporation in Arlington, Virginia.
5
Sherri Rose is an associate professor of biostatistics in the Department of Health Care Policy, Harvard Medical School.
6
Andrew Wilcock is a postdoctoral fellow in the Department of Health Care Policy, Harvard Medical School.
7
Bruce E. Landon is a professor of health care policy in the Department of Health Care Policy, Harvard Medical School.
8
Ateev Mehrotra is an associate professor of health care policy and medicine in the Department of Health Care Policy, Harvard Medical School.

Abstract

Only a small proportion of people with a substance use disorder (SUD) receive treatment. The shortage of SUD treatment providers, particularly in rural areas, is an important driver of this treatment gap. Telemedicine could be a means of expanding access to treatment. However, several key regulatory and reimbursement barriers to greater use of telemedicine for SUD (tele-SUD) exist, and both Congress and the states are considering or have recently passed legislation to address them. To inform these efforts, we describe how tele-SUD is being used. Using claims data for 2010-17 from a large commercial insurer, we identified characteristics of tele-SUD users and examined how tele-SUD is being used in conjunction with in-person SUD care. Despite a rapid increase in tele-SUD over the study period, we found low use rates overall, particularly relative to the growth in telemental health. Tele-SUD is primarily used to complement in-person care and is disproportionately used by those with relatively severe SUD. Given the severity of the opioid epidemic, low rates of tele-SUD use represent a missed opportunity. As tele-SUD becomes more available, it will be important to monitor closely which tele-SUD delivery models are being used and their impact on access and outcomes.

PMID:
30633671
DOI:
10.1377/hlthaff.2018.05134

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