One of the biggest issues is incentive alignment. Even if one insurer launches an initiative to promote whole-person care, that could make actual care on the ground more complicated if they represent only a small part of each practice's business. States can play a role in acting as a neutral convener, allowing regulators, payers, providers, and patients to come together and make sure that the infrastructure and incentives as a whole support effective care.

Aside from total costs, person-reported outcomes, person-reported experience, and provider experience measures are key. If innovations can demonstrate that they achieve meaningful outcomes in behavioral health, empower patients, and improve provider wellbeing, the value case becomes apparent.

This is the question of the day.....how do we convince payers to cover the multitude of services that telehealth can provide. I think the first two steps are the telehealth provider community demonstrating impact through clear, comprehensive data and metrics; and the provider community adopting more of a 'culture of prevention' around pediatric health, in general, but specifically as it relates to mental health. Historically, many of the resources aimed at children have been reactive-- addressing kids in crisis or critical need. If we can continue to demonstrate the impact of earlier interventions (e.g. reduced ER utilization, less absenteeism, improved well being, improved academic performance), it will emphasize to the payer community on the clear value of supporting and funding telehealth services.

Telehealth platforms present the opportunity to increase points of contact with patients and can be leveraged in non-traditional ways. for example, behavioral health screeners can be applied early on in the process of linking kids to care after a need has been identified. Such screeners can provide a sense of severity for the child, and based upon the needs identified, the child can be expedited into care/services. Such screeners represent a shortening of the time to care window that is so significant for many children who have been identified as being in need of support.
Even with a new technology apparatus, traditional services (e.g. case management, care navigation) can be brought in to supplement the telehealth platform and assist families in better understanding how these resources can be leveraged and how to 'work through' the network of support services in place (e.g. social support, primary care services, scheduling/connecting with providers). New strategies can be implemented partnering with other agencies/providers to help close the broadband gap, and also work with modalities that families may be most familiar with (e.g. cell phones, social media).

You can also visit the report landing page for a quick overview of the report: https://www.ama-assn.org/delivering-care/public-health/accelerating-beh…

When optimally utilized my belief is that digital tools used in conjunction with a integrated treatment plan can optimize interventions. This has been shown to be effective in the DOD/VA programs treating PTSD. It has to be codified and part of a treatment regimen that the provider and patient adhere to. In doing this it does complement each component of care and in effect can be used anywhere so there is a multiplier effect especially in rural areas. The more effective and efficient treatment protocol along with telemedicine giving access and optimizing the treating providers time--rather than commuting, does increase access. How much? Possibly 15-20 %. Will it sufficiently address the access issue, no, as we need 30-60% more people to do the work even if optimally provided. W. Beecroft M.D.

I would agree with Dr. Beecroft. Telehealth has been a game changes in many ways including improved efficiencies, increased job satisfaction and has increased access especially for those where transportation to an in-person visit is difficult for a multitude of reasons. That being said, it is only a start to addressing a growing need.