{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:41:02Z","timestamp":1791614462745,"version":"4.3.4"},"reference-count":43,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We examined how the expansion of Medicaid audio\u2010only coverage (MAOC) was associated with changes in mental health visit rates at Federally Qualified Health Centers (FQHCs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data<\/jats:title>\n                    <jats:p>\n                      We used publicly available FQHC\u2010level Uniform Data Systems (UDS) data (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20099606 FQHC\u2010years) from 2016 to 2022. We used information from the Center for Connected Health Policy, Casetext, National Law Review, LegiScan, and other publicly available state telehealth laws and guidelines to map MAOC and other state\u2010level Medicaid and telehealth policy variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>We employed a two\u2010way fixed effects generalized difference\u2010in\u2010differences (DiD) estimator, followed by the Callaway\u2013Sant'Anna DiD estimator, to assess the effect of MAOC on mental health visit rates in FQHCs. The outcome was defined as mental health visit rates, and the key independent variable was MAOC policy implementation. Time\u2010varying state\u2010level covariates, including mental health provider ratio, broadband access, Medicaid and telehealth policies, as well as FQHC\u2010level covariates including the percentage of Medicaid\u2010insured and low\u2010income patients served, were included in the analysis. Subgroup analyses were conducted based on FQHC characteristics including rural\/urban location and the presence of telemental health services (TMHS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Principal Findings<\/jats:title>\n                    <jats:p>\n                      DiD analysis showed no significant effect of MAOC on mental health visit rates across FQHCs. However, subgroup analyses revealed that FQHCs without an existing TMHS experienced a 20.5% increase in visit rates (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), while those with a TMHS saw a 19.73% decrease (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Audio\u2010only telehealth appears to serve as a substitute rather than a complementary modality for in\u2010person or video\u2010based mental health services in FQHCs. Providing MAOC increased mental health visit rates at FQHCs without an established telemental health service, indicating improved accessibility. Given the quality concerns surrounding audio\u2010only telehealth, further research is needed to validate this substitution effect and assess the quality of introducing these services as an option for FQHCs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1475-6773.70107","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T03:54:58Z","timestamp":1774583698000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of Medicaid Audio\u2010Only Telehealth Coverage Policy on Mental Health Visits in Federally Qualified Health Centers"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6900-2483","authenticated-orcid":false,"given":"Khyathi","family":"Gadag","sequence":"first","affiliation":[{"name":"Department of Social and Public Health College of Health Sciences and Professions, Ohio University  Athens Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanika","family":"Arora","sequence":"additional","affiliation":[{"name":"Department of Health Management and Policy University of Iowa College of Public Health  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Kaskie","sequence":"additional","affiliation":[{"name":"Department of Health Management and Policy University of Iowa College of Public Health  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5174-8666","authenticated-orcid":false,"given":"Whitney E.","family":"Zahnd","sequence":"additional","affiliation":[{"name":"Department of Health Management and Policy University of Iowa College of Public Health  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.focus.20190028"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.894370"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1162\/daed_a_02030"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/cts.2020.42"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2013.0133"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.21160"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2024.30.9.978"},{"key":"e_1_2_12_9_1","unstructured":"M.Guth H.Saunders andB.Corallo \u201cMedicaid Coverage of Behavioral Health Services in 2022: Findings From a Survey of State Medicaid Programs. 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