Medicare Telehealth Flexibilities Extended Through September 2025: What It Means for Behavioral Health

A Critical Win for Telehealth Providers and Patients

This past weekend, President Trump signed the Continuing Resolution (CR) to fund the government through September 30, 2025. Along with securing federal funding, this bill extends several key Medicare telehealth flexibilities that were set to expire at the end of March — a crucial win for providers, patients, and the broader healthcare system.

These policies have shaped how healthcare organizations deliver and access virtual care over the past five years. The extension signals that telehealth remains a critical component of modern care delivery, particularly for behavioral health services in underserved communities.

Key Telehealth Provisions Extended

Under the new legislation, the following Medicare telehealth flexibilities will remain in place:

  • Expanded eligibility for telehealth services
  • The removal of geographic restrictions and expanded originating sites allow more Medicare beneficiaries to access care remotely.
  • Continued support for FQHCs & RHCs
  • Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) can continue delivering telehealth services, ensuring access in historically underserved areas.
  • Delayed in-person visit requirements
  • The bill postpones the requirement for an in-person visit before receiving mental health telehealth services, reducing barriers to care.
  • Face-to-face telehealth encounters for hospice eligibility
  • Telehealth can still be used for hospice recertifications, maintaining continuity for patients with serious illnesses.

Additionally, the bill extends funding for community health centers, teaching hospitals, and national service corps programs, which play a key role in supporting behavioral health workforce expansion.

Why This Matters for Behavioral Health

These extensions are not just policy updates — they directly impact patient care, clinician burnout, and healthcare equity. Behavioral health providers have relied on virtual care models to improve access, efficiency, and outcomes, particularly in rural and underserved areas.

Yet, the uncertainty surrounding permanent telehealth policies remains a challenge. As Congress continues to evaluate the future of these flexibilities, healthcare leaders, including those at Iris Telehealth, are advocating for long-term stability in telehealth legislation.

Industry Leaders Call for Permanent Telehealth Protections

While this extension provides temporary relief, many organizations are urging lawmakers to take permanent action. The College of Healthcare Information Management Executives (CHIME) and nearly 100 other organizations recently sent a letter to Congress emphasizing that returning to pre-pandemic telehealth policies is not an option:

“Acting now to extend the policies initially enacted under the pandemic through the end of the year (at minimum) will bring much-needed stability to patients and clinicians. The deadline for the end of these policies comes at a time when patients are struggling with inflationary pressures, clinician burnout, and record-setting Baby Boomer retirements.”

For providers and patients, telehealth has proven its value. The ability to connect with specialists, manage mental health conditions remotely, and reduce strain on emergency departments is vital for the future of care delivery.

What’s Next for Telehealth Policy?

The next step is ensuring these telehealth gains don’t disappear in 2025. While the CR extends these flexibilities through September of this year, there is growing pressure for Congress to act before these flexibilities expire to provide certainty and stability for the industry.

At Iris Telehealth, we remain committed to advocating for policies that empower providers and improve patient access. We will continue to monitor and provide updates on legislative changes, industry movements, and what this means for behavioral health organizations.

Stay Informed

As these discussions evolve, Iris Telehealth will keep you updated on policy changes, best practices, and industry insights to help your organization navigate the future of behavioral health care.

How Leveraging Actionable Data Across Behavioral Health Services Revolutionizes the Patient Journey

Delivering efficient and financially sustainable behavioral health services can be a significant challenge for health systems. However, with the right data tools and strategies in place, health systems can better position themselves to optimize their workflows, better support their patients and providers, and transform their behavioral health service lines.

By honing in on data tracking and visualization, organizations can ensure their behavioral health programs are operating to the highest standards and delivering the best possible patient care.

 

Data tells a story and helps identify opportunities for improvement

Tracking behavioral health data enables healthcare organizations to identify opportunities for improvement and continuously build upon and optimize their action plans.  



“We use data to impact the patient journey throughout the healthcare continuum. Behavioral health touches a lot of different specialties and patients from a lot of different areas. When I think about data-driven insights, I think about measurement-based care where we’re doing more with surveys and capturing trends. Data driven insights evaluates both patient and program trends.”
Zack Buckareff, Director of Product, Iris Telehealth


Data tracking ensures health systems aren’t just meeting immediate needs, but also laying the groundwork for long-term improvement.

One way of conducting data collection could be leveraging behavioral health surveys or looking at claims data to better understand that patient’s journey. These insights highlight patient prescriptions, whether their prescription was filled, or if the patient frequents the emergency department (ED).

There are also standard screenings that some regulatory bodies require – like PHQ-9 for depression or GAD-7 for anxiety. However, the data most critical to improving outcomes depends on the community and the patient population.




“To be actionable, you have to be able to identify what you can take action on. The question becomes, how do you know what action to take? That’s where data comes in. Data helps you identify opportunities for improvement, track progress, and continuously build on your action plan to sustain success.”
Yara Nielsenshultz, RN, MS, CPHQ, Executive Director of Quality


 

While measuring patient and program performance against internal metrics, it’s also important to look at national benchmarks. When your organization looks outside of its own bubble, you can set better metrics and drive conversations around where you’re landing compared to your peers.

Putting all this information together provides a pulse on the patient experience and outlines how a health system’s programs and services are performing overall.

 

How health systems can overcome common barriers to effective data use with visualization tools

While there are many benefits of data-driven care, many health systems face significant obstacles in fully leveraging their data. Due to fragmented workflows, human error, and stigma, behavioral health often lags behind other specialties.

While health systems have troves of behavioral health data, it can be challenging to know exactly what to do with it. However, streamlining processes and investing in tools that integrate data from multiple sources, can help make data accessible and accessible for all stakeholders.

For example, visualizations are incredibly useful for behavioral health data and can transform complex datasets into clear, actionable insights. Dashboards linked to EMRs can help monitor trends, such as patient no-show rates, and make efficient adjustments to improve outcomes.



“[Data visualizations like] dashboards are really great because they allow you to see patterns, identify opportunities, and monitor progress. Once you’ve met your goal, it’s important to check the dashboard periodically to confirm you’re maintaining success. It’s about being proactive and staying on top of changes in real time.”
Yara Nielsenshultz, RN, MS, CPHQ, Executive Director of Quality


While tools like spreadsheets help communicate what’s going on in the patient journey, visualizations bring the stories to life.

 

The future of behavioral health lies at the intersection of technology and care

The future of behavioral health lies at the intersection of technology and care – here’s how we’re seeing trends shaping up in the new year:

  • AI and predictive modeling: These tools can help identify at-risk patients and prevent costly emergency department visits.
  • Behavioral health integration: Connecting behavioral health with specialties like endocrinology or oncology can provide robust, wrap-around care for patients and a reduction in total cost of care or health systems.
  • Ethical innovation: Leveraging data is an essential part to improving key performance metrics, but it must be done responsibly. It’s vital to ensure AI and other technologies are used responsibly, maintaining patient trust and safety.

By staying ahead of these trends, health systems can revolutionize care delivery and ensure behavioral health receives the attention it deserves.

 

Where Iris fits in

Transforming the behavioral health patient journey starts with data. By embracing actionable insights, streamlining workflows, and adopting innovative tools, health systems can deliver the efficient, sustainable care their patients need.

Want to learn how your organization can leverage data to help your patient population? Contact us today to learn more about our services!

Lessons from Healthcare Leaders on Optimizing Provider Scheduling and Show Rates

This month, Iris Telehealth hosted a webinar with community health leaders to discuss how they’re optimizing provider scheduling and driving operational improvements.

Julie Rayne, Behavioral Health Manager at Worcester County Health Department, and Cynthia McAfee, Director of Operations at Golden Valley Health Centers, lent their expertise and insights into how they’re creating sustainable workflows, assessing the benefits of virtual care to support this work, and driving operational improvements.

Patient no-shows and provider scheduling complexities are key challenges in healthcare operations

No-show rates are a consistent challenge in healthcare, with 37% of medical groups reporting increased rates in 2023.

While the reasons behind these rates vary, a 2017 report from the American Hospital Association found that 3.6 million people did not have a ride to their clinician’s office, citing transportation as the third leading cause of missed medical appointments.

Echoing these statistics, McAfee shared that patients at Golden Valley often miss appointments due to transportation, homelessness, or family situations.

In addition to mitigating no-shows, Golden Valley and Worcester Health must also manage provider schedules and workflows, ensuring full schedules, consistent support, and specialized treatment that enables momentum in care.  

Fortunately, by leveraging evidence-based care models and data insights, Golden Valley and Worcester Health have made meaningful strides and improvements for behavioral health patients in their communities.

Leveraging evidence-based care models increased Worcester Health’s no-show rates by 12%

According to the National Alliance on Mental Illness (NAMI), 70% of patients who seek mental health care drop out after their first or second visit, underscoring the importance of engagement from the very beginning of treatment.

To improve engagement and no-show rates, Worcester Health leveraged multiple grants to increase their evidence-based practice models and ensure their providers had the right specializations and concentrations to best support their patients.

As a result of this focus on evidence-based clinical optimizations, Worcester Health’s show rates have increased by 12%.

Reflecting on this increase, Rayne shared that clients were more invested in Worcester’s services because of the increased access to the most in-demand specializations. 

 “Our show rates increased tremendously because clients were more engaged in the services and felt more invested. We focused on our community and the needs assessment and determined what was lacking in our evidence-based models. Then, we sent our therapists to get certified in those models.”
Julie Rayne, Behavioral Health Manager, Worcester County Health Department

 

Rayne shared that Worcester has also optimized caseloads, ensuring patients were getting seen at the frequency they needed to maintain momentum in their treatment. They were also mindful of creating a balance between caseload optimization and size, ensuring caseloads weren’t getting too big while also ensuring schedules were full.

Worcester analyzes this data monthly, looks at schedules daily, and works within their EHR to ensure confirmations and appointment reminders for patients.

Additionally, to help ensure consistent visits, Worcester asks patients to sign a treatment contract. If they miss three appointments in a row, they are discharged from services and must be readmitted.

Worcester also has a grant-funded program that enables them to send a social worker or case manager into patient homes to meet with them and explore their barriers to care.

This wrap-around care enables Worcester to learn if there are additional services patients might need without affecting their provider schedules or no-show rates.

Balancing patient convenience with operational efficiency is a core strategy for future success  

Improving scheduling accuracy and being mindful of not overbooking providers is a critical component of an organization’s operations.

For Worcester, Rayne shared they run weekly no-show reports to identify patient patterns. They also look at the dynamics of a patient’s life and how that might impact their provider’s schedules.

For instance, if a young patient stays with their grandparents for the summer, they plan for that change in the provider’s scheduling, as it provides an opening for other patients to be seen during that time.

Golden Valley uses “MyChart” to allow patients to send messages to their provider rather than requiring the back and forth of a telephone call.

In the new year, Golden Valley is also investing in iPads to leverage in their waiting room to help improve delays and get patients seen more quickly, noting that check-in time matters to the psychiatrist experience.

Then, to help with check-ins and workflows, Golden Valley implemented, “reverse scheduling,” where a Medical Assistant meets with the patient out front, checks them in, and communicates with them at the end of their visit as well.

Start small, build on success, and center patients in your strategy

Patients are the heart of every organization and working with partners who put people first is a key part of any strategy.  

Reflecting on their largest operational improvements, McAfee shared that working with Iris Telehealth has allowed Golden Valley to make improvements at the clinical level.

 “Iris has been excellent in working through and putting together a dashboard that we couldn’t put together fast enough through EPIC reporting. We have great relationships with providers, center managers, and the clinical supervisor of the medical assistants.”
Cynthia McAfee, Director of Operations at Golden Valley Health Centers

 

For Rayne and her team at Worcester, a big operational improvement that has impacted show rates has been their target case management program. This approach helps Worcester learn and solve why a patient might be missing appointments.

Rayne also shared that the therapists Worcester has leveraged through Iris has been instrumental to their teams.

“I can’t say enough about our Iris therapists and the way they micromanage their own schedules and balance it. If they have a client they want to see, they reach out to them. If someone no-shows, they get the client in to ensure they’re getting the services they need.”
Julie Rayne, Behavioral Health Manager, Worcester County Health Department

 

Prioritizing communication and a deep knowledge of your patient population delivers results

McAfee shared that her top piece of advice for organizations tackling this work is to remember that it’s their obligation to do research to increase access, noting that research needs to include understanding of referral sources and identifying clinical locations based on that geography and access.

For Golden Valley, they looked at referral sources, geography, and where the patients were coming from. Then, they tried to make sure they had a 12-month run rate because of the calendar year and the summers.

“We brought in one provider at a time, and it allowed us to learn our processes, workflows, and what wasn’t going well. Then, we could adapt them before the second provider joined. Those are probably the biggest common denominators – keeping lines of communication open – with your care teams and vendor, Iris Telehealth.
 If you don’t have those open lines of communication, the ability to take a criticism and turn it into an opportunity, there’s no way you can help patients.”
Cynthia McAfee, Director of Operations at Golden Valley Health Centers

At Worcester, they’ve found great partnership opportunities within their community. Whether that’s local social services, parole and probation, juvenile services, schools, or doctor’s offices, they ask for evaluations and recommendations from them twice a year.

Worcester consistently analyzes how things are going with their supervisors and clerical staff and reviews agency-wide client feedback annually.

Learn more about how virtual care can optimize scheduling

We are grateful for the time these leaders shared with us! Thank you for your partnership and for all the incredible work you are all doing to care for your community and support your clinicians!

Weren’t able to make it to the webinar? You can watch the full conversation here. If you’d like to learn more and figure out the next steps to integrating virtual care into your organization, you can contact us here.

The Transformative Impact of Virtual Behavioral Health Integration: A Specialist’s Perspective

Over the past decade and a half, the field of behavioral health has undergone significant changes. However, one transformation stands out among the rest: the integration of virtual behavioral health services into primary care settings. This groundbreaking shift is not only changing the way we provide care, but it is also fundamentally altering patient outcomes and reshaping the structure of our entire healthcare system.

 

Virtual care breaks down traditional barriers to behavioral health access

The traditional model of separate physical and behavioral healthcare has long created unnecessary obstacles for patients. Consider this: when a primary care physician identifies signs of depression during a routine visit, the traditional referral process often results in only 50% of patients actually following through with behavioral health appointments. The reasons are numerous: stigma, transportation issues, wait times, and the challenge of navigating multiple healthcare systems.

Virtual behavioral health integration dissolves these barriers. By embedding behavioral health services within primary care settings and leveraging technology for delivery, we’re seeing remarkable improvements in both access and outcomes.

 

Virtual care enables timely intervention and improved outcomes

Virtual behavioral health integration brings several key advantages:

Immediate Access

The integration of virtual care into primary care services allows for immediate access to behavioral health specialists during a virtual visit when mental health concerns are identified. This timely intervention not only prevents conditions from worsening but also reduces the risk of patients falling through the cracks. 

Additionally, for organizations without local access to behavioral health specialists, the use of virtual care can address these gaps and provide long-term strategic benefits for both providers and patients. By utilizing virtual care, primary care providers have a seamless connection to behavioral health specialists for patient referrals, enabling them to collaborate on medication dosages and facilitate referrals to higher levels of care.

Increased Engagement

Virtual care removes geographical constraints and time barriers. Patients can connect with specialists from their homes, workplaces, or any private space. This convenience has led to a marked decrease in no-show rates—clinics have experienced a 29% reduction in missed appointments after implementing virtual integrated services. 

Enhanced Collaboration

Virtual platforms enable seamless communication between primary care providers and behavioral health specialists. Doc-to-doc consults and referrals lead to more coordinated care plans and better management of complex conditions, creating a more holistic patient experience and increasing patient satisfaction.

 

Behavioral health integration creates significant cost savings for health systems

The benefits of virtual behavioral health integration extend beyond individual patient care to affect entire health systems:

Cost Reduction

By addressing behavioral health issues early and in conjunction with physical health, health systems see significant cost savings. Studies show that patients with untreated behavioral health conditions typically incur 2-3 times higher medical costs than those receiving appropriate care.

Resource Optimization

Virtual integration allows health systems to maximize their behavioral health resources. Specialists can serve multiple primary care locations without travel time, increasing their availability and effectiveness. 

Improved Population Health Management 

The data collected through virtual platforms enables better tracking of population health trends and outcomes. This information helps health systems allocate resources more effectively and develop targeted interventions for high-risk populations. 

 

Effective behavioral health integration drives real-world outcomes like decreased LOS and wait times

 At Iris, our own experience driving virtual behavioral health integration with our partners has shown: 

  • 96% reduction in patient wait times  
  • 38% improvement in depression symptoms over eight weeks of care 
  • 80% decrease in emergency department length of stay  

Additionally, emergency department visits for behavioral health crises decrease by up to 14.2% when virtual integrated care is available. 

Perhaps most significantly, virtual behavioral health integration is catalyzing a cultural shift in how we think about healthcare delivery. The artificial separation between physical and mental health is dissolving, replaced by a more holistic, patient-centered approach.

As we continue to evolve our healthcare delivery models, virtual behavioral health integration will play an increasingly central role. The future likely holds even greater integration of digital tools, artificial intelligence for risk prediction, and expanded capabilities for remote monitoring and intervention.

The integration of virtual behavioral health services into primary care isn’t just a temporary solution or a pandemic-driven necessity—it’s a fundamental reimagining of how we deliver comprehensive healthcare. By breaking down traditional barriers, improving access, and enabling true collaboration between providers, we’re moving toward a more effective, efficient, and equitable healthcare system.

For health systems considering implementation of virtual behavioral health integration services, the evidence is clear: this approach not only improves patient outcomes but also strengthens the entire healthcare ecosystem. The initial investment in technology and workflow redesign is far outweighed by the long-term benefits in terms of both patient health and system efficiency.

Our challenge now is not whether to implement these changes, but how to accelerate their adoption and ensure they reach all populations who could benefit from them. 

If you’d like to learn more about Virtual Clinic and how you can integrate behavioral health into your organization’s primary care service line, please reach out today.

The Time is Now to Sustainably Scale Behavioral Health Integration

Behavioral health integration is not a new idea. It started to garner mainstream traction in the 1970s, and in 2024, nobody disputes the impact of integrating mental and physical health.

It is unquestionably the right thing for patients and total cost of care.

The last fifty years have brought innovative ideas, pilots, and learnings — but as an industry, we have yet to drive widespread adoption and success. At Iris Telehealth, we believe that’s going to change. The data, care models, and technology have evolved to make driving scalable and sustainable clinical and financial outcomes possible. 

Let’s talk about what we’ve learned as an industry, where we’re going, and why the time is now to drive widespread adoption of behavioral health integration. 

 

Why hasn’t behavioral health integration lived up to the hype yet?

In entrepreneurship, there is a maxim that the success of any business comes down to 5% having the right strategy and 95% having great execution.

With behavioral health integration (BHI), the strategy needed to find success is no different. By integrating the right resources into a patient’s care team, we can drive better outcomes and total cost of care. 

However, the biggest challenge to date is scalability. There are no doubt great experiences, data, and outcomes. But results have been difficult to scale across patients of higher acuities, within rural geographies, and with financials that incentivize their organizations to invest over the long haul.

From our conversations with customers, too many have given up, or have stopped scaling their programs because they run into operational or financial roadblocks that prevent them from achieving their ultimate mission. 

 

So, how can we overcome this challenge to solve behavioral health integration?

There are a few key evolutions in the market that have changed the game: the ability to integrate virtual care locally, to algorithmically identify the patients that need care the most, and the development of care models that are financially sustainable.

Virtual care in behavioral health is a game changer. The unfortunate reality is that 70% of counties in our country do not have a licensed child psychiatrist and 60% do not have a licensed psychiatrist.

Additionally, virtual care allows you to leverage resources across geographies to ensure they’re being used efficiently so smaller populations can still receive great care. 

Virtual care has to be part of the story, but it comes down to the “how.”  

The answer is dedicated virtual care teams with local integration. There must be trust between virtual and in-person teams with shared goals, technology platforms, and communication mechanisms.  

The on-site teams must truly see the virtual providers as an extension of their teams – something that can only be established if the virtual providers know the local culture, are operating on the same technology platforms, communicate constantly, and have aligned goals.  

The second critical ingredient is utilization of data to measure and drive success. Data has unlocked our ability to determine “who should receive care” and “when.”

The reality is some patients are at higher risk of escalating than others, and the data exists within EMRs to intelligently prioritize who should get care first.

This process could mean prioritizing the referral queue to ensure patients in highest need care first or it could mean proactively identifying patients that need care, even if they have not been referred.

The data, algorithms, and technology are all there, we just have to do the work.

Finally, we have decades of learning around the optimal care model that we should apply going forward. Navigation assessments must be part of the story to ensure each patient is getting clinically appropriate care from a provider working top-of-license.

We need to incorporate short-term care models as clinically appropriate.

There must be a care team approach to ensure patients of all acuities can receive the best care for their specific needs. And, a need to collaborate with the broader team, and community providers, to ensure patients are receiving continuous, quality, whole-person care. 

If we do all these things, the financials follow – both on a fee-for-service basis and from a total cost of care perspective. We have proven that it is possible to deliver great clinical care while delivering a positive operating margin for our partner health systems. 

 

So, what’s next for behavioral health integration?

We cannot give up on the idea of behavioral health integration.

If we take the learnings we’ve had as an industry over the last few decades and apply them, we can absolutely scale BHI across entire populations in a way that delivers sustainable financials and fantastic clinical outcomes — all while increasing patient and provider satisfaction. 

We believe Virtual Clinic is the answer to behavioral health integration.

Our Virtual Clinic approach leverages a cross-functional care team to ensure patients who need help first, get seen first. They’re able to get the appropriate care plan for their needs and are supported throughout their care journey. Virtual Clinic integrates behavioral health services into unique patient journeys to ensure their mental health is always supported.

If you want to learn more about this service and how we can help your organization address behavioral health needs in a financially sustainable way, feel free to contact us today.

You can also learn more about our services here and read our case study to see them in action.

Why Leveraging Virtual Behavioral Health Services Drives Patient Satisfaction in the ED

Identifying ways to address behavioral health needs and improve patient satisfaction in the emergency department (ED) is not only beneficial for your health system, but it’s also the right thing to do for patients.

If there isn’t adequate access to behavioral health services across your organization and within your community, patients may feel they have no choice but to seek behavioral health care in the ED. When that happens, ensuring your ED has adequate behavioral health resources to meet that patient demand can be a substantial difference-maker for patient satisfaction, quality, and even length of stay.

Health systems have an opportunity to help patients get the quality, life-changing care they need and deserve.

By embracing the patient and leveraging virtual behavioral health services to ensure they’re well taken care of during their time in the ED and have a good plan after discharge, health systems are better positioned to retain patients and help them throughout their healthcare journey (even beyond the ED).

54% of U.S. hospitals have no psychiatrist available for ED and inpatient consultation services

In 2022, 6 million people sought care for mental, behavioral, or neurodevelopmental disorders in the ED.

A study from the Mayo Clinic on specialty psychiatric services in emergency departments found the following results:

  • 59% of hospitals say they transferred a psychiatric patient to a different hospital due to lack of available services
  • Only 27% of hospitals had consultation services available for psychiatric patients
  • 54% of U.S. hospitals had no psychiatrist available for medical ED and inpatient consultation services

With the high demand for behavioral health care in the hospital setting, it is critical your organization provides quick access to quality care.

 

“For many health systems, the emergency department is becoming like an inpatient unit. For organizations that partner with a telehealth solution like ours, patients can be seen by a psychiatrist or a Psychiatric Nurse Practitioner (PMHNP) in less than an hour of when they present to the ED.
From there, we can work with the ED staff on starting or restarting necessary medications or guiding the course of treatment – which makes for a better patient experience and smoother workflows for the on-site care teams.”
Dr. Thomas Milam, Chief Medical Officer

 

Across the board, patients report high satisfaction rates with telehealth.

For example, an article from the American Medical Association, cites 79% of patients were very satisfied with the care they received during their last telehealth visit, with 73% saying they would continue using virtual care in the future.

60% of patients said they waited 10+ hours to be seen by a mental health professional in the ED

Today, patients seeking behavioral health support in the ED spend a lot of time waiting and don’t always receive adequate information or resources to support them long-term and prevent them from returning to the ED.

A survey from the National Alliance on Mental Illness found that patients with psychiatric emergencies in the ED experienced the following:

  • 60% of patients waited 10+ hours to be seen by a mental health professional in the ED
  • 54% said there was no information given to them about prescribed medications
  • 65% were not given information about outpatient or community care

Anecdotally, patients also reported feeling very isolated and not taken seriously in their ED experience.

If you’re looking for ways to improve the patient experience, increasing access to dedicated behavioral health services and specialists in the ED is a positive step in the right direction to ensuring patient needs are being addressed.  

Virtual care helps reduce the amount of time patients spend in the ED

Patient satisfaction stems from the ability to address specific needs and track progress to ensure important metrics are being met.  

On the operational side, having insights into how your clinicians are performing can help optimize care, ensure quality treatment, and help keep patients safe.

Through our strategic approach to quality management, we’ve helped our partners reduce the length of stay in their MedSurg units by 0.5 days, increased ED discharge rates from 55% to 62%, and reduced their length of stay in the ED from 12 to 9 hours.

Overall, our partners have seen an 80% improvement in ED throughput by leveraging a strategy that ensures patients get to the right level of care and have the behavioral health care they need to address their specialty behavioral health needs.

Get started with behavioral health integration

Every hospital’s central value boils down to caring for patients and ensuring they’re well taken care of – body and mind. Whether your ED has leveraged virtual before or is looking for innovative solutions that will support patients long-term – there’s no bad place to start.

If you’d like to learn more about how Iris Telehealth can help integrate behavioral health into your organization, please contact us today.

2025 CMS Physician Fee Schedule Final Rule: Key Changes to Behavioral Health and Telehealth

On November 1, the Centers for Medicare & Medicaid Services (CMS) released their 2025 Medicare Physician Fee Schedule through a comprehensive fact sheet that breaks down all the planned changes across the health care system.  

Here’s a look at how these changes will affect the behavioral health and telehealth landscape as we turn the corner into 2025 along with some insights from our Chief Medical Officer, Dr. Thomas Milam, on how we can interpret these changes.

Average payment rates under the PFS will be reduced by 2.93% in CY 2025

While the new ruling contains several positive updates, the PFS reduction in payment rates by 2.93% may have cascading impacts across your organization that you may have to prepare for.

While a decrease wasn’t unexpected, it still may present challenges for those affected as this reduction will put less money in the hands of healthcare workers and their organizations.

“Everything we do in medicine has a relative value unit (RVU) assigned to it – every procedure and every patient encounter – so even an incremental decrease is less money going to doctors, hospitals, and facilities during a time where there’s a lot more patients and higher acuity.”
Dr. Thomas Milam, Chief Medical Officer

 

 

CMS will preserve and expand the scope of and access to telehealth services

Without congressional action, the pre-COVID-19 statutory limitations in place for Medicare telehealth services will resume, including geographic restrictions and service limitations in which practitioners can provide telehealth services.

CMS has expressed intentions to preserve important flexibilities in their authority and expand the scope of, and access to, telehealth services. However, we’re still waiting on the supportive data and legislative updates that will be critical to such efforts.

“The CMS Behavioral Health Strategy has a lot of important initiatives where telehealth could play a major role in keeping patients well and out of hospitals and emergency departments. We have every reason to believe CMS, patients, and providers want to continue leveraging telehealth in patient care–we’ve been doing it, and we should keep doing it.”
Dr. Thomas Milam, Chief Medical Officer

 

 

CMS is leaning into greater suicide prevention and flexibilities for OUD treatment

To expand access to behavioral health care, CMS is taking action towards safety planning. When properly executed, this planning can go a long way towards preventing suicide.

CMS is currently finalizing separate coding and payment under the PFS describing safety planning interventions for patients in crisis, including those with suicidal ideation and those at risk of suicide or overdose.

“CMS is leaning in more to support efforts to identify people at risk for suicide, and they plan to have additional reimbursement modeling for services to move towards a zero-suicide policy. Suicide rates remain high in all age groups, and among veterans as well, so we should all be doing everything we can to screen, intervene, and prevent such loss of life — telehealth will continue to play a big role in such efforts.
There will be additional G-codes in the system that will cover some additional services for suicide screening, assessment, and management in keeping with the success of the 988-suicide hotline.”
Dr. Thomas Milam, Chief Medical Officer

 

CMS is also finalizing telecommunication technology flexibilities for Opioid Use Disorders treatment services – allowing people to receive care without an in-person visit.

 

“I was pleased to see there are still a lot of flexibilities around opiate treatment programs in the 2025 PFS. The high risk of intentional and accidental deaths associated with opiates and the fentanyl crisis warrant continued efforts in early screening, management and prevention strategies.
The opiate epidemic is still a major concern for CMS and among health care providers, so allowing flexibilities to  se telehealth and other technologies to keep patients engaged in ongoing treatment is imperative.”
Dr. Thomas Milam, Chief Medical Officer

 

Prior to the COVID-19 PHE, if someone needed buprenorphine to stay well and avoid withdrawal and relapse, they had to go to a clinic in person, attend to their appointments for med management and therapy, and get drug screens – everything had to be done in person. 

Now, a lot of this process takes place over the phone and helps lower the risk that someone might relapse or overdose. As policies around this patient population evolve, it’s critical that CMS and SAMSHA continue working together to recognize the vulnerability and importance of people struggling with opiate use disorder.

New G-codes can help promote provider collaboration

CMS is finalizing six G-codes that will be billed by people who have limitations in their statute to services for diagnosis and treatment, mental illness, psychologists, social workers and management. These codes will mirror current interprofessional consultation and CBT codes.

There’s also more recognition in healthcare that provider communication around patient care is of high importance.

For example, eConsults weren’t previously paid for, but now there’s recognition that collaboration is real work and adds value for patients and providers. Reimbursing healthcare providers for their interprofessional communication and identifying the work that different care teams are engaged in together to keep patients well is an important step in the right direction.

CMS also shared they are finalizing a policy to continue allowing direct supervision via interactive, real-time audio-visual platforms to extend various types of supervision for providers who may require it such as like nurse practitioners, therapists, physician’s assistants.

While there seems to be hesitancy around using audio-only modalities for supervision and care delivery, they will hopefully still be viable options given the rural locations of so many patients and providers in the US.

Where Iris fits in

At Iris, we believe in a future that helps more people get the high-quality behavioral health they need and deserve – regardless of where they live. Virtual care is an important part of the future of healthcare and will continue to increase access to care for those who need it most.

Want to learn more about what the final rule means for your organization? Reach out to talk to someone today – you can contact us here!

You can also get more information and read more about the new CMS rule here.  

How Integrating Behavioral Health Can Improve Women’s Health Service Lines

Behavioral health integration is a crucial part of ensuring holistic care in women’s service lines. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), among women with mental health conditions, 27% have a serious mental illness and 20% suffer from mood or anxiety disorders during pregnancy.

In a webinar hosted by Becker’s Hospital Review, healthcare leaders from Carilion Clinic dove into how they’re approaching behavioral health in their women’s service lines, shared best practices for integration, and offered strategies for better patient outcomes.

Carilion Clinic has taken steps to integrate behavioral health services into their women’s health service lines, and Dr. Jennifer Wells, reproductive psychiatrist and Director of Women’s Mental Health Services, and Dr. Jaclyn Nunziato, OBGYN and Executive Director of Huddle Up Moms, shared how they think about ensuring all patients have access to care that’s trauma informed and culturally sensitive. Please read below for a breakdown of the key insights they shared during that conversation.

Untreated behavioral health conditions can have negative ramifications on clinical outcomes

As an OBGYN, Dr. Nunziato shared that mental health was never in her training, yet behavioral health conditions are more commonly found in women than other common illnesses covered in regular screenings.

“I found patients I was seeing for years were sitting on these mental health issues, everyday struggles, and transitions throughout their reproductive journey. I would hear time and time again [patients saying], ‘Nobody’s ever asked me how I’m doing […] mentally.’ I found screening them even at a routine visit has really opened my eyes to the need and to the lack of resources.”
Dr. Jaclyn Nunziato, OBGYN, Executive Director of Huddle Up Moms

 

Dr. Nunziato went on to say that untreated behavioral health conditions have negative ramifications on clinical outcomes and that gaining a better level of expertise in mental health has made her a better provider.

Reproductive psychiatrist Dr. Jennifer Wells, Carilion Clinic’s Director of Women’s Mental Health Services shared that she has witnessed mental health stigma decreasing, a credit to Carilion Clinic and having providers who are more open to behavioral health.

In previous times, Dr. Wells said people would show up and talk about their depression, but not mention things like substance use.

“As we’ve grown in our ability to talk about diseases and provide education to the people around us, it’s allowed this great evolution of how we think about mental illness. And now I think some of that is happening in the perinatal space.”
Dr. Jennifer Wells, Director of Women’s Mental Health Services at Carilion Clinic

 

She says persons of reproductive age and parenting women are more comfortable sharing their fears and concerns about being a parent. Dr. Wells also shared that the ability to express these fears and concerns opens the opportunity to educate, listen, and find better ways to help people manage their anxiety and depression.

Acknowledging that hormonal shifts are important markers of a women’s health journey can help reframe the way we approach conversations about behavioral health

When defining the difference between “women’s health” and “women’s mental health,” Dr. Wells shares that they’re intimately connected.

“Women’s health has come to the forefront because we recognize the journey of a woman through her life is characterized by significant hormonal changes. Hormonal shifts are responsible for many downstream effects like mood disorders.”
Dr. Jennifer Wells, Director of Women’s Mental Health Services at Carilion Clinic

 

Dr. Wells also shares that a woman’s life takes a dramatic shift every 10, 15, and 20 years, which can create a shifting of mental health. This journey starts during adolescence, matriculating through middle school to high school, where someone might experience premenstrual dysphoric disorder. Then in fertile years, a woman might experience perinatal mood and anxiety disorders.

If a woman undergoes fertility treatment or infertility, they might experience depression or anxiety. Then, there’s the postpartum period that brings a greater risk for mood and anxiety disorders. Then, there’s menopause.

When discussing hormonal shifts, there are also important considerations around stigma. Dr. Nunziato shared that acknowledging hormonal shifts places value on where a woman is in her journey, where in another time, it was seen as something that was “all in someone’s head.”

Dr. Wells said that would like to see the conversation move beyond a woman being histrionic and can’t control their hormones to the idea that hormones are neuroactive steroids that change the biochemistry and neuroreceptors of someone’s brain, making mood disorders more common.

“Hormones are very real, and we need to talk about them – it’s a part of a woman’s life. Women live their lives through connection and emotional ties to other people. As these connections change through life, it’s no surprise that it happens concurrently with hormonal changes that exacerbate and ameliorate mood disorders.”
Dr. Jennifer Wells, Director of Women’s Mental Health Services at Carilion Clinic

 

 

How to integrate behavioral health into women’s health

Dr. Nunziato said the first thing a provider can do to integrate behavioral health is to become more comfortable in the mental health space and talking about mental health with your patients, noting, “You are somebody that values mental health and is willing to ask about it, provide screenings, be more educated about it. The more you do it, the more you gain a network and find the resources available in your area.”

When considering at what point a provider should refer to a specialist, Dr. Wells says it depends on provider comfort, sharing that each provider comes from a different training background with varying familiarity on certain conditions, like PMDD or major depressive disorder.

For providers, she recommends getting more comfortable talking about mental health and increasing their knowledge base. Dr. Wells also shared that most people are comfortable prescribing an SSRI, but if it goes beyond their scope and level of comfortability, they can reach out for an e-consult.

“The high prevalence of mental illness and substance use disorders in America can be co-occurring, including conditions like anxiety and depression, ADHD, bipolar, and schizophrenia. We know that primary care providers, family doctors, and pediatricians are at the frontlines, but often need support from mental health experts for medication management, therapy, or substance use issues.”
Dr. Thomas Milam, Chief Medical Officer, Iris Telehealth

At Carilion Clinic, they have e-consult services built into their systems, and providers can reach Dr. Wells via calling, texting, or a referral to her clinic. There are also perinatal mental health lines where providers can get connected to a specialist within 30 minutes.

In Virginia, Dr. Wells and Dr. Nunziato are heading their state’s perinatal mental health line called “VMAP for Moms+,” designed to help providers caring for pregnant persons or those contemplating pregnancy. These lines help create networks of good information that’s evidence-based and data driven.

Dr. Nunziato shared that she was seeing wait lists from six months to a year and to help increase access, they leveraged a risk-stratification approach. She noted that not everyone needs to see a psychiatrist and might do great with a peer support group or rely on their own OBGYN.

Addressing gender in women’s healthcare

When discussing women’s health, it’s important to consider all facets of the female experience, including transgender care.

For Dr. Wells, who often works with transgender patients, she shared that her practice is intentional about using the right terminology and understand this population faces higher rates of substance use disorder, abuse, and intimate partner violence.

Dr. Nunziato added for transgender patients trying to get pregnant or going through menopause, they’re also dealing with physiologic changes and stressors that need to be addressed and often aren’t recognized.

“It’s up to us to implore our teams to be accountable, respectful, and as open as possible. When I have transgender patients who are getting pregnant, it’s a great way to remind my staff (from the front desk all the way to the person doing their transvaginal ultrasound) that we need to be mindful and respectful of everyone’s individual needs.”
Dr. Jaclyn Nunziato, OBGYN, Executive Director of Huddle Up Moms

 

Dr. Wells shared that as the Director of Women’s Health she understands that “women” doesn’t always apply and it’s important to find alternatives. Dr. Wells goes onto say that she tries to elevate her own vocabulary, be sensitive to the person in front of her (however they identify) and educate herself on how best to meet their needs.

Get started with behavioral health integration

We are so grateful for the time Dr. Wells and Dr. Nunziato shared with us. Thank you for your partnership and for all the incredible work you are all doing to expand behavioral health to your community!

Weren’t able to make it to the webinar? You can catch the full video here. If you’d like to learn more and figure out the next steps to integrating behavioral health into your women’s health service lines, you can contact us here.

How to Onboard Virtual Providers Seamlessly into your Care Team

When integrating virtual providers into your organization to augment your behavioral health strategy it’s critical to ensure the onboarding of those virtual providers is as seamless as possible. Successful onboarding sets the tone for the entire relationship and working with an experienced partner that manages the process can be a major benefit.

In this blog, we’ll review tried and true strategies our partners have leveraged to effectively onboard providers for long-term success.

1. Assess your resources and lean on your partner

Before bringing on virtual providers, it can be helpful to assess your current onboarding resources and workflows. It might also be helpful to talk with your on-site providers about what to expect and discuss how your new providers will benefit your organization overall.

“We thought in the long term, it was going to create a situation where we could offer more flexibility when looking at full-time staff members. Even if they weren’t working full-time in a virtual capacity, they would have that tool as part of their tool belt. 
So, whether it was because of illness or convenience, it’s an important arrow in our quiver to be able to expand virtual health to include providing services on the inpatient end.”
Dr. James Anderson, Chief of the Department of Psychiatry at Basset

Partnering with a behavioral health organization that takes care of logistical steps in your onboarding process can save you a lot of time and resources. For instance, at Iris Telehealth, our Practice Managers (PMs) help manage the entire onboarding process and the day-to-day logistics after onboarding completes.

Our PMs ensure providers feel supported throughout their onboarding process and have resources they need, whether that’s the right equipment, or assistance with things like the EMR, or general support.

2. Check all your credentialing boxes to ensure desired start date

Onboarding the right provider types and specialists might mean working with a provider who lives in another state. When that happens, you may need to allocate more time to that provider’s licensing and credentialing processes. In some circumstances, credentialing can take months and delay a provider’s start time, so it’s best to get started as soon as possible to avoid any road bumps.

When we’re working to onboard providers, our credentialing team stays in close contact with clinicians, providing follow-up and retrieving documentation to ensure the process moves forward as efficiently as possible.

Our Medical Staff Services (MSS) team can estimate the length of time credentialing  will take based on your state’s requirements and provide an accurate start date.

Iris Providers Share Their Experience with Virtual Care

 

 

At Iris, we’ve achieved 96% of on-time start dates, ensuring clinicians can start providing care as soon as possible.

 

 

 

3. Conduct a tech check to ensure everything runs smoothly

Working in a virtual environment versus an in-person one comes with unique considerations. For example, virtual providers may require special equipment or you may need to ensure they have seamless access to your EMR. For successful onboarding, it’s crucial to conduct tech checks and have trial run throughs. While many providers are familiar with virtual care, some may need assistance.

When you’re working with patients virtually, it’s important to ensure everything goes smoothly. For example, providers should confirm their audio is working properly, their backgrounds are appropriate, and there aren’t any interruptions.

“We have our systems in place in terms of our morning rounds. We have the computer system up and running. We recently just got a fish-eye lens camera, so I have better visibility of seeing everyone in the morning meetings, which has been fantastic.”
Dr. Tisa Ayuso, Virtual Medical Director, Basset Health Network

 

Ensuring your processes are thorough is extremely important and partnering with an organization that values quality is crucial. At Iris, we run all tech checks for providers and deliver 24/7 IT support during onboarding and beyond – your virtual provider is never left alone to deal with technical snags and your on-site team’s resources aren’t eaten up by troubleshooting technology.

Along with technical checks, confirming familiarity with the EMR is also important. Our PMs ensure they know as much about your EMR as the provider does – that way they can be of assistance if ever needed.

4. Create a trusted training plan and prep for necessary steps

Upon your provider’s first day, there will be a lot for them to learn, and having a structured plan in place can be incredibly useful. Whether that looks like scheduling intro meetings for them with on-site providers or letting them explore the EMR before they see their first patient, giving them tools to settle to their new role can be a huge help.

It’s also helpful to think of your provider as you would as an on-site team member – ensuring they understand the workflows and inviting them to meetings.

When creating your onboarding plan, here are a few trainings you might consider:

  • IT orientation
  • HR orientation
  • Support staff introductions
  • EMR training
  • Conducting a dry run

At Iris,  we account for these trainings and considerations when we help onboard a new provider. We also go over important trainings like crisis overview, data entry, appointment scheduling, emergency protocols, and much more.

Want some extra help with onboarding? Here’s where Iris fits in.

With all the logistical considerations that come along with onboarding a virtual provider, having a partner that’s been there before can serve as a huge advantage.

Want to learn more about how Iris can help your organization make provider onboarding seamless? Contact us today!

How Virtual Care Can Support Value-Based Care

Achieving value-based care for your health system can increase quality patient care, improve provider satisfaction, and reduce total cost of care for your organization.

But how can your health system achieve these benefits? Keep reading to learn how to advance your journey toward value-based care in a scalable and financially sustainable way.

Value-based care improves patient outcomes

Value-based care helps hold providers accountable for improving patient outcomes and gives them more flexibility to provide the right care at the right time.

While many health systems aim to provide value-based care, it’s not always possible given the need to treat a large variety of ages, acuities, and diagnoses.

For example, due to increasing patient volumes, many hospitals must triage patients who need referrals and immediate help in the ED. This approach causes delayed care and no follow-up, creating a barrier to providing the care that patients need and deserve.

Due to growing referral queues, follow-up challenges, and inefficient workflows, helping patients receive a high level of care isn’t always an option. Before an organization can be proactive and lean into a value-based care model, they must help patients with effective care that facilitates better patient outcomes and fills gaps in ambulatory and post-acute behavioral health care. 

Fortunately, strategic and purposeful virtual behavioral health care services can help health systems address need in their ED and throughout their hospital.

Filling gaps in care across the behavioral health continuum

Every health system faces a hierarchy of needs regarding patient care, and helping those with the highest acuity is top priority. To help the most patients and remain financially sustainable, investing in the right behavioral health programs and resources is essential.

What does a financially sustainable behavioral health program look like in practice? Let’s take a look at two essential solutions health systems are leveraging today:

  • On-Demand Services: This solution helps organizations decrease the burden on their care teams by providing 24/7 ED support – improving wait times and costly and inefficient psychiatric boarding in the hospital.
  • Virtual Clinic: By integrating behavioral health through the patient journey, this solution helps improve holistic care and ultimately decrease long-term costs.

Both of these solutions deploy fully integrated quality tracking and data analytics to drive optimization and ensure these programs run effectively and continue improving patient outcomes.

Benefits of value-based behavioral health care

Once an organization achieves value-based behavioral health care for their population, they reap many benefits, some of which, according to The Commonwealth Fund include reduction in cost care and improvement of quality of care. The Commonwealth Fund also highlights how value-based care can transform collaboration and allow providers to spend more time facilitating care related to counseling or screening for social needs.

Additionally, according to a behavioral health analysis by Evernorth Health Services, treating behavioral health conditions in outpatient care is directly tied with a reduction in medical and pharmacy costs. In their analysis, they highlight savings up to $2,565 per person over the 15 months following a diagnosis and up to $3,321 per person over the 27 months following a diagnosis.   

Here are a few other key benefits that value-based behavioral health care can provide:

  • Healthier and more satisfied patient population
  • More fulfilled providers facilitating quality care
  • Lower total cost of care that helps you meet financial objectives
  • Better care so patients don’t escalate

At Iris Telehealth, our partners have successfully leveraged our services and helped move their organization towards a value-based care model. At Geisinger Health, we’ve helped procure the following results with Bridge Care Services:

  • 83% reduction in referral backlog (18,000 – 3,000) within 6 months
  • 40 % of their psychiatry referrals were diverted to a lower, more cost-effective level of care
  • 38% improvement in their patient’s depression symptoms over eight weeks of care

To read the full story, check out our case study outlining how they leveraged our Bridge Care Services program.

Get started on your journey towards value-based care mental health services

If you’d like to learn more about how we can help your organization help your hospital or health system address patient needs in your community, contact us today