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. 2025 Feb 3;8(2):e2459606.
doi: 10.1001/jamanetworkopen.2024.59606.

Disparities in Substance Use Disorder Telehealth Services

Lauryn Saxe Walker  1 , Manying Cui  2 , Jonathan Cantor  3 , Melody Craff  4 , Cheryl L Damberg  3 , John N Mafi  2   3 , Katherine L Kahn  2   3
Affiliations

Disparities in Substance Use Disorder Telehealth Services

Lauryn Saxe Walker et al. JAMA Netw Open. .
No abstract available

Plain language summary

This cross-sectional study evaluates whether telehealth utilization is associated with changes in payer-based and rural-urban disparities in substance use disorder treatment.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Cantor reported receiving grants from the National Institute on Aging and the National Institute of Mental Health, receiving personal fees from Chestnut Health, and receiving conference funding from the Government Accountability Office outside the submitted work. Dr Mafi reported receiving grants from the National Institute on Aging (grant 1K76AG064392 01A1) during the conduct of the study as well as grants from Arnold Ventures, the Commonwealth Fund, and the National Institute on Aging outside the submitted work; Dr Mafi was permitted free use of the Millman MedInsight Health Ways calculator tool from Milliman MedInsight and provided unpaid consulting to the Agency for Healthcare Research and Quality and Milliman MedInsight. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Percentage Change in Substance Use Disorder Treatment (SUDT) by Payer and Rurality, 2019 to 2023
A, Despite increases in telehealth SUDT across all payers, corresponding reductions in in-person SUDT resulted in overall decreases in SUDT use per 100 000 for individuals covered by Medicaid and overall increases for individuals covered by commercial insurers and Medicare Advantage. Adults who are dual eligible for Medicaid-Medicare are included as Medicaid members to create a single payer group for low-income individuals. B, All modalities of SUDT increased for both rural and urban individuals; however, overall SUDT increased for rural individuals to a greater extent than urban individuals. Rurality is determined by Rural-Urban Commuting Area Codes.
Figure 2.
Figure 2.. Distribution of Payer and Rurality Populations Across Substance Use Disorder Treatment (SUDT) Modalities, 2023
A, As opposed to telehealth SUDT being proportional to overall SUDT utilization for any given payer, proportionality varied by payer. Specifically, Medicaid telehealth SUDT was disproportionately low (74.9% of all telehealth SUDT) compared with overall SUDT (93.0% of overall SUDT). In contrast, rural telehealth SUDT was proportionate to overall SUD (6.3% and 6.2%, respectively). Adults who are dual eligible for Medicaid-Medicare are included as Medicaid members to create a single payer group for low-income individuals. Rurality is determined by Rural-Urban Commuting Area Codes.
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References

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