News: Privately insured patients’ telehealth use up 50-fold during start of pandemic

CDI Strategies - Volume 15, Issue 13

Telehealth accounted for 24% of outpatient consultations among privately insured, working-age adults during the first four months of the COVID-19 pandemic, up from 0.3% for the same period in 2019, HealthLeaders reported.

The study, published in the Journal of the American Medical Association (JAMA) Open Network, analyzed Blue Health Intelligence-compiled claims data from 36.6 million private insurance plan members who were of working age and continuously enrolled during the study period. A total of 15 million telehealth claims were submitted during the March to June 2020 study period, with 75% involving video, 9.2% using audio-only telephone, 3.3% conducted either by email or chat while 13% were unspecified.

Mental health was the top virtual consultation, with 46% of appointments taking place via telehealth, while 22% of medical consults were virtual, HealthLeaders reported.

In COVID-19 "hot spots”—states with a COVID-19 prevalence at least 1.5 times the national average—36% of all consults were telehealth versus 21.6% in low COVID-19 areas. The study also found that the greater the COVID-19 prevalence in a specific ZIP code, the higher the use of telehealth.

About 24% of consultations in urban areas were via telehealth, compared to only 14% of visits from more rural settings. Age and number of chronic diseases were associated with more frequent telehealth consults, with individuals age 18 to 49 and those with more than two chronic conditions using telehealth the most.

The study also found that:

  • Total overall total medical care costs, including hospitalizations, dropped 15%, from $358 to $306 per person per month, from 2019 to 2020. Persons with at least one COVID-19-related consult in 2020 had more than three times the medical costs compared to those with no COVID-19-related services—$1,701 per member per month versus $544, a difference of $1,157.
  • In-person, outpatient visits decreased by 37%, from an average of 1.63 visits per enrollee during the three-month 2019 study period to an average of 1.02 visits per enrollee in 2020. However, since telehealth visits filled much of the gap, the total combined in-person and virtual encounter rate dropped only 18% between 2019 and 2020.
  • For persons with at least one COVID-19-related insurance claim, the average number of in-person and telehealth consults were about 30% higher than the average number of claims for persons with no COVID-19-related visit. One-quarter of COVID-19-related consults were via telehealth versus 23% for non-COVID-19-related consults.

Editor’s note: This article was originally published by HealthLeaders. ACDIS coverage of telehealth related topics can be found here. To read all of ACDIS’ coverage of the COVID-19 pandemic, click here.

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