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Analysis

Private Insurance Telehealth Claims Grow by 4,347%

By Mandy Roth  
   June 03, 2020

FAIR Health report shows a dramatic increase in the use of private telehealth insurance claims in the United States, led by a 15,503% increase in the Northeast this March compared to last year.

The coronavirus pandemic has dramatically changed the way healthcare is delivered in the United States, accelerating a transition to virtual care. For those seeking data points, a FAIR Health study out this month indicates a national increase of 4,347% in March compared to the same month last year.  The Monthly Telehealth Regional Tracker compares telehealth claim lines, which it defines as an individual service or procedure listed on an insurance claim, from the privately insured population, excluding Medicare and Medicaid.

As the pandemic hit, health systems and providers ramped up their telehealth services to reduce the risk of disease transmission from in-person visits and to continue providing care to patients who need it. The report indicates total telehealth claim lines volume rose from 0.17% in March 2019 to 7.52% in March 2020.

Related: Telehealth Expansion During Coronavirus Pandemic Changing Physician-Patient Relationship

FAIR Health is a national, independent nonprofit organization, which says it is dedicated to bringing transparency to healthcare costs and health insurance information.

The March 2020 report demonstrates significant regional differences in the use of telehealth. The greatest increase was recorded in the Northeast, which was hard-hit by the pandemic in March. Telehealth claim lines grew 15,503%, compared to the previous year. Although not as dramatic, increases were seen in all other regions, led by a 3,427% increase in telehealth claim lines growth in the South, 2,842% in the Midwest and 1,986% in the West.

During February, before the rapid escalation of the pandemic in the United States, telehealth growth was substantially lower, according to FAIR Health. Compared to February 2019, telehealth medical claims lines only grew by 121% nationally.

Related: Survey: Patients Equally Satisfied with Virtual Encounters Compared to In-Person Visits

The report also tracks data by diagnosis. Some highlights include:

  • The top diagnosis in March 2020 was mental health conditions, which comprised 33.91% of claims.
     
  • This was followed by acute respiratory diseases and infections at 8.12%, joint/soft tissue diseases and issues at 4.9%, and hypertension at 3.22%.
     
  • Hypertension was not among the leading reasons for telehealth claims in 2019.
     
  • FAIR Health notes a surprising drop in acute respiratory disease and infections compared to the 18.38% reported in March 2019, noting that this "may indicate that many people with acute respiratory symptoms, fearing they had COVID-19, preferred this year to see a physician in person."

Monthly Telehealth Regional Tracker also examines data by CPT codes. The top three reasons for telehealth visits during March 2020 included:

  • Established patient office or other outpatient visit, typically 15 minutes
     
  • Established patient office or other outpatient visit, typically 25 minutes
     
  • Psychotherapy, 60 minutes

“In this period of change, FAIR Health’s Monthly Telehealth Regional Tracker opens a timely window on how telehealth is being transformed," FAIR Health President Robin Gelburd said in a news release.

Mandy Roth is the innovations editor at HealthLeaders.


KEY TAKEAWAYS

The report details dramatic increases in the use of telehealth spawned by the coronavirus pandemic.

Mental health conditions were the leading reason patients used telehealth, followed by acute respiratory diseases and infections, joint/soft tissue diseases and issues, and hypertension.


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