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Medicaid Beneficiaries With Mental Illness Treated Through An Outpatient Telepsychiatry Clinic Had 38% Lower Inpatient Hospitalization Rates

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By OPEN MINDS Circle

Medicaid consumers using an outpatient psychiatry clinic’s services had a 38.0% lower rate of hospitalizations (274.3 hospitalizations per 1,000 consumers) than those not using such services (442.6 hospitalizations per 1,000 consumers), according to a recent study. Both groups had similar per-member per-month (PMPM) costs to Medicaid across the categories analyzed. The researchers said the findings suggest that outpatient telepsychiatry care could play an important role in reducing hospital admissions.

The researchers analyzed data for 5,372 Montana Medicaid beneficiaries who received services from Frontier Psychiatry using Humbi AI’s national Medicaid analytics platform. These individuals were compared to an equal number of controls who did not use services from Frontier Psychiatry. PMPM costs were analyzed for the following types of utilization:

  • Durable medical equipment: $16.62 PMPM for the telepsychiatry group and $16.17 PMPM for the control group
  • Emergency department: $3.35 PMPM for the telepsychiatry group and $3.94 PMPM for the control group
  • Home health or community-based services: $0.06 PMPM for the telepsychiatry group and $2.11 PMPM for the control group
  • Hospice: $0.99 PMPM for the telepsychiatry group and $0.1 PMPM for the control group
  • Inpatient hospital: $187.5 PMPM for the telepsychiatry group and $280.9 PMPM for the control group
  • Capitation payments: $8.15 PMPM for the telepsychiatry group and $10.41 PMPM for the control group
  • Outpatient hospital: $4.93 PMPM for the telepsychiatry group and $32.02 PMPM for the control group
  • Professional costs: $464.0 PMPM for the telepsychiatry group and $388.4 PMPM for the control group

Overall monthly PMPM costs to Medicaid were statistically similar between the groups, at $685.50 for those using Frontier Psychiatry’s services and $734.00 for those not using Frontier Psychiatry’s services across all categories analyzed. Those using telepsychiatry had a 17.9% lower rate of admissions from emergency departments (47.7% of hospitalizations) than those not using telepsychiatry (58.1% of hospitalizations), the study found.

These findings were reported in Medicaid Costs And Outcomes For Patients Treated In An Outpatient Telepsychiatry Clinic by John L. Havlik, M.D., MBA; Reza H. Ghomi, M.D., MSE; Na An, MA; and colleagues. The goal was to investigate Medicaid costs and care outcomes associated with the use of an outpatient telepsychiatry clinic. The researchers concluded that additional investment in outpatient telepsychiatry services is warranted across health care systems.

For more information, contact: John L. Havlik, M.D., MBA, Affiliate, Department Funds Resident, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Room 1211, Palo Alto, California 94304; Email: jhavlik@stanford.edu; Website: https://medicine.stanford.edu/profiles/john-havlik