Podcast Summary:
In this episode of the Hospital Finance Podcast, host Kelly Ness welcomes Denise Gaulin, Windham Brannon’s Healthcare Consulting Leader to discuss the implications of a sweeping piece of legislation informally referred to as the One Big Beautiful Bill. The conversation centers on how this bill is reshaping access to behavioral health services through telehealth, particularly in rural and underserved communities.
Background and Intent of the Bill
Denise begins by clarifying that the bill’s original intent was not primarily focused on behavioral health. Instead, it was designed to reduce unnecessary federal costs and eliminate regulatory roadblocks that hinder productivity and business growth. However, one of its most significant unintended consequences has been its impact on telehealth access, especially for behavioral health services.
Historically, behavioral health services were expected to be delivered through face-to-face interactions, which posed challenges for patients in remote areas. The bill has now opened the door for telehealth-based behavioral health services, which marks a pivotal shift in how care is delivered.
Medicaid Cuts and Their Consequences
Despite the positive strides in telehealth access, Denise highlights a major concern: cuts to federal Medicaid funding. These reductions are expected to have a devastating impact on healthcare coverage, particularly in rural states that rely heavily on Medicaid to fund mental health services. Studies suggest hospitals could lose up to $25 billion annually, and the number of uninsured individuals could rise by 14 million by 2034.
This funding gap is especially troubling for communities that already face limited resources. Denise emphasizes that while telehealth offers new opportunities, the reduction in Medicaid support could undermine these gains, making it harder for hospitals and providers to sustain services.
Telehealth as a Beacon of Hope
One of the most promising aspects of the bill is its permanent support for telehealth coverage. Denise notes that this could be transformative for rural and underserved populations, where access to behavioral health professionals is scarce. Telehealth allows patients to receive care without traveling long distances or waiting months for appointments
However, she cautions that technology access remains a barrier. Many rural areas lack reliable internet or devices and older populations may be uncomfortable using digital platforms. Denise stresses the importance of community education and marketing to raise awareness about telehealth options and reduce stigma or confusion around its use.
Early Outcomes and Patient Experiences
When asked about early feedback from patients, Denise shares that while there is optimism around quicker scheduling and improved access, significant delays still exist. This is especially true for new patient visits. In rural areas, it can take months to get an appointment with a provider. Behavioral health services are no exception.
She believes it’s still too early to fully assess the bill’s impact. There’s hope that telehealth will improve access and reduce wait times, but challenges like insurance coverage, technology literacy and provider availability must be addressed. Denise expresses concern that mental health needs might be deprioritized if these issues aren’t resolved.
Children, Adolescents and Community Settings
The conversation shifts to how the bill affects children and adolescents, particularly in school and community settings. Unfortunately, Denise reveals that the bill doesn’t directly support behavioral health access for these groups. The lack of Medicaid funding is again a central issue.
However, she encourages organizations to explore alternative funding sources, such as grants and state-level programs, to fill the gap. She emphasizes that time is critical, as even grant funding is becoming more competitive and targeted by federal oversight.
Building Stronger Behavioral Health Systems
Denise discusses the importance of local partnerships in building robust behavioral health support systems. With federal funding shrinking, state and local governments must collaborate more closely than ever. She points to the closure of community hospitals as a warning sign and urges stakeholders to prioritize communication and coordination.
She also highlights the need for clear pathways to care, including marketing efforts that inform communities about available resources. This includes those without insurance or in self-pay situations. Behavioral health services often operate in these contexts, and awareness is key to ensuring people know help is available.
Advocacy and Public Policy
To sustain improvements in behavioral health access, Denise calls for ongoing advocacy. Patients, providers and community leaders must engage with policymakers to ensure that behavioral health remains a priority. She believes public policy plays a crucial role in shaping funding, access and acceptance of telehealth services.
She also reiterates the importance of investigating grant opportunities, especially at the state and local levels, and encourages healthcare organizations to be proactive in securing resources. The future of behavioral health access depends on strategic planning, community engagement and policy alignment.
Closing Thoughts
Kelly wraps up the episode by thanking Denise for her insights. The discussion highlights how the One Big Beautiful Bill is reshaping behavioral health care in America by offering new opportunities through telehealth while also presenting significant challenges due to Medicaid cuts and infrastructure limitations.
Denise leaves listeners with a call to action: stay informed, build partnerships and advocate for change.
