Patterns of Telehealth Use Among Rural Medicaid Beneficiaries

Document Type


Publication Date



telehealth, rural, behavioral health, Medicaid, MRHRC, mental health

Publication Title

Journal of Rural Health


[Abstract from the Journal of Rural Health]

Purpose: Few studies have examined telehealth use among rural Medicaid beneficiaries. This study produced a descriptive overview of telehealth use in 2011, including the prevalence of telehealth use among rural and urban Medicaid beneficiaries, characteristics of telehealth users, types of telehealth services provided, and diagnoses associated with telehealth use.

Methods: Using data from the 2011 Medicaid Analytic eXtract (MAX), we conducted bivariate analyses to test the associations between rurality and prevalence and patterns of telehealth use among Medicaid beneficiaries.

Findings: Rural Medicaid beneficiaries were more likely to use telehealth services than their urban counterparts, but absolute rates of telehealth use were low—0.26% of rural nondual Medicaid beneficiaries used telehealth in 2011. Psychotropic medication management was the most prevalent use of telehealth for both rural and urban Medicaid beneficiaries, but the proportion of users who accessed nonbehavioral health services through telehealth was significantly greater as rurality increased. Regardless of telehealth users’ residence, mood disorders were the most common reason for obtaining telehealth services. As rurality increased, significantly higher proportions of telehealth users received services to address attention‐deficit/hyperactivity disorder (ADHD) and other behavioral health problems usually diagnosed in childhood.

Conclusions: These findings provide a baseline for further policy‐relevant investigations including examinations of changes in telehealth use rates in Medicaid since 2011. Reimbursement policies and unique rural service needs may account for the observed differences in rural‐urban Medicaid telehealth use rates.


This research was a product of the Rural Telehealth Research Center and was supported by a Cooperative Agreement with the Federal Office of Rural Health Policy (FORHP), Health Resources and Services Administration (HRSA), Department of Health and Human Services (HHS) (grant number 6 UICRH29074‐01‐01). The information, conclusions, and opinions expressed in the manuscript are those of the authors, and no endorsement by FORHP, HRSA, or HHS is intended or should be inferred.

Acknowledgments: The authors acknowledge Erika Ziller, PhD, of the Maine Rural Health Research Center for her contributions to the conceptualization and design of this study. We thank Marcia Ward, PhD, and Kimberly Merchant, MA, both of the University of Iowa and Rural Telehealth Research Center, for their comments on an earlier draft of the manuscript.

Funding Organization

Federal Office of Rural Health Policy, Health Resources and Services, U.S. Department of Health and Human Services