Hispanic/Latino Communities Lead Telehealth Visits for Mental Health Services During COVID-19
July 14 2021 - 9:27AM
Business Wire
While telehealth helped bridged some gaps,
Anthem’s State of the Nation’s Mental Health data showed
significant differences continued among communities of color
The Hispanic/Latino community was the most engaged in telehealth
for mental health visits in 2020 – adopting the technology more
than any other ethnic or racial group, according to a new analysis
of Medicaid members in 14 states as part of an Anthem, Inc. State
of the Nation’s Mental Health special report during National
Minority Mental Health Awareness Month.
Telehealth served as a silver lining during the pandemic and a
strong alternative to seeing clinicians and counselors in person.
Telehealth visits – either via video or phone — for people with an
existing mental health condition significantly increased during the
height of the pandemic. Visits that started in the single digits
before COVID-19 accounted for 49 percent of all Medicaid mental
health visits during a six-month period in 2020. Telehealth
regulations lifted during COVID-19 have assisted in removing
barriers people may have experienced in accessing telehealth.
Overall gaps in getting mental health care between races and
ethnic groups remained essentially the same before and during
COVID. A higher percentage of Hispanic-Latinos were already
receiving in-person or telehealth mental health visits before
COVID-19. By greatly boosting the numbers of people using
telehealth, COVID-19 may have jumpstarted broader adoption of
telehealth for mental health conditions – especially with
Hispanics/Latinos. In fact, during COVID-19, almost 40 percent of
Hispanic/Latino members had a telehealth visit, while White members
had 34 percent, Asian members had 33 percent and Black members had
28 percent.
While telehealth did boost visits during COVID-19, it didn’t
make up for the dramatic drop in in-person visits for all races and
ethnic groups. And there were significant differences among them.
In fact, Black people had the lowest percent of combined telehealth
and in-person visits – 56 percent – before COVID-19 and remained
the lowest with 49 percent after COVID-19.
On average, Black people had 7 percent fewer mental health
visits compared to White people with similar demographic, clinical
and socio-economic backgrounds. The rates are particularly
noteworthy as surveys have indicated that people of color were
experiencing more stress and mental health conditions than other
populations in 2020 and people of color were disproportionately
impacted by COVID-19.
“There are likely many reasons behind the differences in mental
health care visits – including issues that prevent people from
seeking care, such as medical injustices and a history of receiving
culturally insensitive care,” said Anthem Chief Health Officer,
Shantanu Agrawal, MD. “Health equity is a key driver for mental and
physical well-being. To achieve equity in our healthcare, we need
to understand where and why barriers to health exist, and then
couple these insights with the scale and scope of Anthem to drive
changes to a new system of health, that puts equity at the
center.”
Historically, major depression and anxiety are underdiagnosed at
rates of 32-40 percent less in Black and Hispanic/Latino
communities, according to the BCBS Health Index. The American
Psychological Association says that lower diagnosis rates are
likely driven by lack of provider understanding of cultural
differences, stigma around diagnosis or treatment and barriers
getting care.
For Medicaid members with an existing mental health diagnosis,
the most common telehealth diagnoses were anxiety, depression and
bipolar disorder, according to the special State of the Nation’s
Mental Health report. High blood pressure was among the top five
diagnoses for Black, Asian and Hispanic/Latino people, while high
cholesterol was a top five medical diagnosis for Hispanic/Latino
and Asian people. Opioid use disorder was one of the top five
diagnoses for White people, while severe back pain was a top
diagnosis for Black people. These data reinforce that mental health
and physical health are connected and improving one can help the
other.
“While telehealth wasn’t a panacea in eliminating health equity
gaps, it helped boost connectivity for all and made Internet visits
possible when COVID temporarily closed physical doors, allowing
health care to continue to be delivered with some semblance of
normalcy,” Agrawal said. “This study is a key reminder that
technology alone won’t be sufficient to bridge this gap and the
bridge may not be the same for all people. However, it may be the
connector needed by certain communities or geographic areas.
Clearly, outcomes during the pandemic would have been much worse
without telehealth.”
Interestingly, members used telehealth and in-person mental
health services similarly whether they lived in an urban or rural
area.
Anthem will continue to evolve the following efforts to ensure
that it can bridge the gaps for all people that take into
consideration their specific needs. Some of these efforts
include:
- Social drivers of health benefits that can assist in improving
health equity for physical and mental health.
- Peer programs, such as those offered by Anthem and Beacon, may
also help create trust by pairing members with someone who has the
same lived experience.
- Education and informative efforts that involve connections to
trusted sources, like churches and even barbershops, have been
shown to have greater impact on community acceptance of health
services.
- Continuing Medical Education programs, such as
www.mydiversepatients.com, that train clinicians about bias and
cultures different from their own, and go a long way in creating
stronger, more trusting and culturally responsive relationships
between clinicians and patients.
Anthem supports making permanent many of the telehealth policy
changes that have occurred during COVID beyond the public health
emergency. These include legislative and regulatory policies
that:
- Allow consumers to see doctors or clinicians from their
home.
- Allow providers with appropriate medical licensure to deliver
services across state lines, and
- Eliminate pre-COVID-19 policies that placed prohibitions on
prescribing medications via telehealth.
About the study
The study is based on a claims analysis of Medicaid members who
had existing mental health diagnoses, including bipolar, major
depression and anxiety, and substance use disorder. Mental health
visits are defined as office visits for evaluation and management
of mental health conditions through either telehealth, inclusive of
video or phone, or in-person.
Members were between 18 and 64 years old with a mental health
diagnosis prior to COVID based in at least two medical claims.
Members were compared during two six-month study periods: the
pre-COVID period from Mar. 1, 2019 to Aug. 31, 2019 and the COVID
period from March 1, 2020 to Aug. 31, 2020. Data was adjusted for
age, gender, socio-economic status, rurality, state of residence,
Elixhauser comorbidity index score, prior health conditions and
healthcare utilization.
About Anthem
Anthem is a leading health benefits company dedicated to
improving lives and communities, and making healthcare simpler.
Through its affiliated companies, Anthem serves more than 116
million people, including more than 43 million within its family of
health plans. We aim to be the most innovative, valuable and
inclusive partner. For more information, please visit
www.antheminc.com or follow @AnthemInc on Twitter.
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Lori McLaughlin 317.407.7403 lori.mclaughlin2@anthem.com
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