Behavioral Health Telehealth

The importance and validity of virtual therapy has become particularly evident in the current reality of the COVID–19 pandemic. Utilization of virtual therapy for behavioral health (BH) diagnoses was quite modest prior to 2020.

To help avoid further spread the virus, Highmark is actively encouraging our members to utilize telehealth: virtual visits (provided by an in-network provider) and telemedicine (provided by a Highmark-contracted telemedicine vendor). The use of telehealth allows members easier access to care to address their emotional well-being. The treatment of behavioral health diagnoses and substance use disorders (SUDs) are challenges for all health plans today, including Highmark.

From January 2020 through December 2020, the following number of members1 had one or more of the diagnoses below:

  • Depression – 225,261 (8.88%)
  • SUD – 157,966 (6.23%)
  • Anxiety – 154,089 (6.08%)
  • Other BH Diagnoses – 189,994 (7.49%)

The use of virtual therapy can help our members receive the care they need, especially as the COVID-19 pandemic continues.

Why is Telehealth Important?

In 2019, 61.2 million Americans (5.9% more than 2018) were diagnosed with a mental and/or SUD.2 To complicate this, there has been an increasing shortage of BH Professionals across the United States. It is estimated that there may be a deficit upwards of 250,000 BH Practitioners (including Psychiatrists, BH Nurse Practitioners, BH Physician Assistants, Clinical Counselors/Psychologists, SUD Counselors/Social Workers, and Family Therapists) by the year 2025.3

While some of those with a diagnosed SUD and/or mental illness do not perceive a need for treatment, there are gaps in access to care for those who do need treatment. According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2019 report:2

  • 20.4 million children and adults 12 years of age or older have been diagnosed with a SUD with 89.7% not receiving treatment
  • 51.5 million adults 18 years or older are diagnosed with Any Mental Illness (AMI) with 55.2% not receiving treatment
  • 13.1 million adults 18 years or older have been diagnosed with Serious Mental Illness with 34.5% not receiving treatment
  • 9.5 million adults 18 years or older have been diagnosed with Co-Occurring AMI and SUD with 51.4% not receiving treatment
  • 3.8 million adolescents between the ages of 12 and 17 have been diagnosed with Major Depressive Episode with 56.7% not receiving treatment

Telehealth visits can help provide care to patients who cannot travel to a provider’s office and/or in areas where there are not as many behavioral health providers. The American Psychiatric Association (APA) issued the following position statement in 2015: “Telemedicine in psychiatry, using video conferencing, is a validated and effective practice of medicine that increases access to care. The American Psychiatric Association supports the use of telemedicine as a legitimate component of a mental health delivery system to the extent that its use is in the best interest of the patient and is in compliance with the APA policies on medical ethics and confidentiality.”4 Additionally, increasing evidence has demonstrated that telebehavioral health care is generally as effective as in-person care for a number of common behavioral health conditions.5


1These percentages are out of the 2,535,727 members in PA, DE, and WV who were actively enrolled in Cotiviti chronic conditions for behavioral health for the 2020 year.

The number of members identified utilizing BH Virtual Therapy in 2019 in PA, DE, and WV through claims was 9,253 members for 30,015 visits. In 2020, that number rose to 177,904 members (↑1823%) for 1,503,724 visits (↑4909%).

2Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-001, NSDUH Series H 55). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved 09/23/2020 @

3U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Workforce, National Center for Health Workforce Analysis: National Projections of Supply and demand for Selected Behavioral Health Practitioners: 2013 – 2025 , November 2016, retrieved 09/23/2020 @

4American Psychiatric Association: What is Telepsychiatry? Retrieved 09/23/2020 @

5Lazur,B., Sobolik, L.., King, V.: Telebehavioral Health: An Effective Alternative to In-Person Care; Issue Brief October 2020, retrieved 03/04/2021 @