Factors Associated With Telehealth Usability Among Medicaid Beneficiaries With Mental Illness: A Cross-Sectional Analysis of Consumers and Providers

Background: Telehealth offers a flexible and effective alternative to in-person behavioral health services, with users generally reporting high satisfaction. However, several barriers can limit equitable access among Medicaid beneficiaries. Aim: This study aimed to examine factors associated with Telehealth Utilization Questionnaire (TUQ) scores among Medicaid beneficiaries and providers. Methods: A cross-sectional research design was employed to collect data from beneficiaries and providers at five community mental health centers and managed care organizations. Descriptive statistics, chi-square analyses, and hierarchical regression analyses were used to analyze the data. Results: Most Medicaid beneficiaries (n = 181) were 36 years or older, female, White non-Hispanic, and resided in urban locations. Among them, 46.4% used telehealth 50.0% or more of the time and reported moderate to high trust in providers’ scores (TPS) and TUQ scores. There were no significant differences in telehealth usage based on residence or diagnosis. Regression analysis revealed that TPS was significantly associated with telehealth use frequency. Most Medicaid providers (n = 188) were 36 years or older, female, White non-Hispanic, and practiced in rural locations. There were no significant differences in the proportion endorsing providing care via telehealth to 50.0% or more of their patients based on practice location or job role. Regression analyses identified that practicing in urban locations and providing care via telehealth to 50% or more of their patients were significantly associated with telehealth use frequency. Conclusion: Trust in providers is a key driver of perspectives on telehealth usability among Medicaid beneficiaries, while practice location and utilization frequency significantly influence providers’ perspectives on telehealth usability for delivering mental and behavioral healthcare. These findings suggest the importance of fostering trust among beneficiaries and addressing location-based barriers for providers to optimize telehealth usage.