Population Health and Health Policy

Understanding the Business Case for Telemental Health in Rural Communities


Telemental health has been promoted to address long-standing access barriers to rural mental health care, including low supply and long travel distances. Examples of rural telemental health programs are common; there is a less clear picture of how widely implemented these programs are, their organization, staffing, and services. There is also a need to understand the business case for these programs and assess whether and how they might realize their promise. To address these gaps, a national study was conducted of rural telemental health programs including an online survey of 53 programs and follow-up interviews with 23 programs. This article describes the current landscape and characteristics of these programs and then examines their business case. Can rural telemental health programs be sustained within current delivery systems and reimbursement structures? This question is explored in four areas: need and demand, infrastructure and workforce, funding and reimbursement, and organizational fit and alignment. [Journal Abstract]

Suggested Citation: Lambert, D., Gale, J., Hartley, D., Croll, Z., & Hansen, A. (2015). Understanding the business case for telemental health in rural communities. Journal of Behavioral Health Services and Research. doi: 10.1007/s11414-015-9490-7 [epub ahead of print].

FMI: John Gale

Publication Type: 
Journal Article
Publish Date: 
December 22, 2015

Exploring the Business Case for Children's Telebehavioral Health


This brief, authored by John Gale, M.S. and David Lambert, Ph.D. from the University of Southern Maine's Muskie School of Public Service, Maine Rural Health Research Center, explores terminology, reimbursement and business issues, and provides examples from the field in the development of telebehavioral health services. In the first section, the authors place children’s telebehavioral health within the context and demands of today’s rural healthcare system, where the majority of children’s telebehavioral health services are delivered. They then describe three examples of the use of telebehavioral health to serve children, adolescents, and families in rural communities. The brief concludes by exploring the business case for telebehavioral health including the issues and challenges of service delivery, coordination, and financing. This brief is informed by a national study of telemental health (serving children, adults, and older persons) in rural health systems conducted by the authors and updated to reflect the latest information on three case examples.

For more information, please contact John Gale at john.gale@maine.edu

Suggested citation: Gale J, Lambert D. Exploring the Business Case for Children's Telebehavioral Health. Washington, DC: The Technical Assistance Network for Children's Behavioral Health, The Institute for Innovation & Implementation; March, 2015. Brief.

Publication Type: 
Research and Policy Brief
Publish Date: 
March 2, 2015

Pearson and Shaler Present Community Paramedicine Study Findings at EMS Conference

Karen Pearson and George Shaler of the USM Muskie School presented findings from their evaluation of the Maine EMS Community Paramedicine Pilot Program at the EMS Conference in Rockland on November 13, 2015. The Community Paramedicine Pilot Program is comprised of 12 pilot sites located across the state of Maine. Community Paramedicine is the practice by an emergency medical services (EMS) provider in an out-of-hospital setting, providing patient evaluation and treatment within their scope of practice, directed at preventing or improving a medical condition as requested or directed by a physician. Pearson and Shaler found that, overall, Maine's Pilot Program highlighted the need for innovative solutions to integrating care coordination for patients with chronic conditions or who are at high risk for re-hospitalization.
photo: Karen Pearson with Community Paramedicine poster at EMS Conference in Rockland, ME

Rural Maternal Smoking Behaviors Policy Brief Shared at APHA

Jean Talbot, Research Associate with the Maine Rural Health Research Center, and colleagues have published their study of the role of rural residence and single motherhood as risk factors for smoking. Their findings indicate that rural mothers are significantly more likely than their urban counterparts to be smokers, smoke frequently, and smoke heavily, even after adjusting for factors known to increase smoking risk. Talbot suggests that policymakers should consider methods for extending insurance coverage for smoking cessation interventions through the Affordable Care Act and Medicaid. Additionally, anti-smoking initiatives at the local, state, and national levels could play an important role in decreasing rural-urban disparities in smoking-related morbidity and mortality.

Gale and Lenardson present webinar on opioid study

John Gale and Jennifer Lenardson, research associates at the Maine Rural Health Research Center, University of Southern Maine will present a webinar June 25, 2015 at 1pm ET in which they will provide an overview of their research on the prevalence of opioid use disorders in rural and urban settings and discuss issues with regard to workforce and providing treatment. They will be joined in the webinar by Holly Andrilla from the WWAMI Rural Health Research Center. The one-hour webinar is free and open to the public. Log in information: https://hrsa.connectsolutions.com/gateway_rural_opioid_research/ Enter as a guest and type your name. Use your phone and call 888-469-2038. Participant passcode: 3363788.

Ziller receives President’s Metropolitan University Leadership Award

Erika Ziller, Muskie School of Public Service Senior Research Associate, and Deputy Director, Maine Rural Health Research Center, was presented on June 19, 2015 with the President's Metropolitan University Leadership Award: Staff Award for Funded Research - a demonstrated commitment to addressing local, state, and national issues which contributes knowledge, and service in a particular field.Ziller was one of 6 recipients of the first-ever President’s Metropolitan University Leadership Award given to faculty and staff who best exemplify commitment and dedication to the University and who also demonstrate positive and effective relationships with students, their colleagues, and also, the surrounding community.
photo: Erika Ziller receives staff award

First Steps Phase III Initiative: Improving Oral Health and Healthy Weight in Children


This is the final evaluation report of the First STEPS (Strengthening Together Early Preventive Services) Phase III Improving Oral Health and Healthy Weight in Children learning initiative. The evaluation assessed changes in rates of oral health and healthy weight preventive services and evidence-based office processes among practices that participated in the initiative, as well as related systems changes. This report presents key findings, summarizes lessons learned in implementing practice changes, and describes challenges in using CHIPRA, HEDIS and other oral health and healthy weight measures at the practice-level to inform quality improvement.

This report was written by Carolyn Gray and Kimberley Fox at the Cutler Institute of Health and Social Policy, Muskie School of Public Service at the University of Southern Maine. The work was conducted under a Cooperative Agreement between the Maine Department of Health and Human Services and the Muskie School of Public Service at the University of Southern Maine and is funded under grant CFDA 93.767 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS) authorized by Section 401(d) of the Child Health Insurance Program Reauthorization Act (CHIPRA).

These contents do not necessarily represent the policy of the U.S. Department of Health and Human Services, and one should not assume endorsement by the Federal Government. The views expressed are those of the authors and do not necessarily represent the views of either the Department or the School. For further information regarding this report, or the broader evaluation of the local IHOC initiative, please contact Kim Fox at kfox@usm.maine.edu.

Suggested Citation:Gray, C., & Fox, K. (2015). First STEPS Phase III initiative: Improving oral health and healthy weight in children. (Final Evaluation Report). Portland, ME: University of Southern Maine, Muskie School of Public Service.

Publication Type: 
Publish Date: 
June 10, 2015

Research staff present at National Conference

Andrew Coburn, Zach Croll, John Gale, Jean Talbot, and Erika Ziller of the Maine Rural Health Research Center presented their research at the 38th Annual National Rural Health Association Annual Conference held in Philadelphia April 14-18.

Gale receives NRHA Volunteer of the Year award

John Gale, Senior Research Associate with the Maine Rural Health Research Center, was presented with the 2015 National Rural Health Association (NRHA) Volunteer of the Year Award at NRHA's 38th Annual Rural Health Conference April 16 in Philadelphia. To view the video go to :https://www.youtube.com/watch?v=xowct9wOYME&list=PLrLzXxrhUwSf-FTs0Erkcj4E8i_3AMAFe&index=10.
photo: John Gale at national Rural Health Association

Ziller and Joly present at Sino-American International Research Forum

As part of the 2-day Sino-American International Research Forum, Dr. Erika Ziller and Dr. Brenda Joly of the USM Muskie School presented their research on Rural Implications of Medicaid Expansion under the Affordable Care Act and Partnerships to Improve Community Health. Participants in the forum will have their research published in the NAAAS monograph series.


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