Dive Brief:
- The volume of telehealth claim lines increased more than 8,335% in April 2020 compared to April 2019 as the pandemic continues to drive utilization, according to the newest analysis of insurance trends by nonprofit FAIR Health.
- Mental health diagnoses continue to drive the visits, followed by joint and soft tissue conditions and hypertension, suggesting more privately insured patients turned to telehealth to manage chronic conditions during the first peak in U.S. COVID-19 cases.
- The Northeast, hit hardest by the coronavirus in April, saw a 26,209% increase in telehealth claim lines that month, while the Midwest, South and West saw their volumes increase by 6,753%, 6,038% and 3,967%, respectively. It's likely usage in the Southwest will jump in June and July given spiking COVID-19 cases in the regions already surpassing April's high.
Dive Insight:
Though states have reopened public spaces and businesses, hospitals across the country have resumed elective procedures and doctors are reporting rising in-office visits, surging caseloads concentrated in the South and West are threatening to walk back the progress the U.S. made to control the virus over the past few months.
The pace of hospital recovery stalled in the last week of June, according to Jefferies analysts, with traffic to Texas, New York and Arizona facilities all lower than the week prior.
Though there's some evidence telehealth use has dampened as states reopened, continued struggles for hospitals could continue driving virtual care utilization until the U.S. gets the virus, which has almost 2.9 million confirmed cases to date, under better control.
FAIR Health has tracked the evolution of telehealth use on monthly basis since January using its database of more than 31 billion privately billed medical and dental claims. The data excludes Medicare and Medicaid, though Medicare beneficiaries have also been using virtual care in record numbers. Roughly 1.3 million members were using telehealth services in mid-April, compared to just 11,000 in early March. That's an increase of 11,718% in a month and a half.
The broad consumer uptake has sparked calls for the federal government to make permanent relaxed regulations that contributed to broad utilization after the national emergency ends. CMS made a small step in this direction late last month by allowing telehealth visits for home health services, with a big catch: They can't be reimbursed as a visit.
Congress would have to step in for more sweeping changes. Lawmakers on both sides of the aisle have said they support keeping up the momentum.
In both 2019 and 2020, mental health conditions were the most common diagnosis for telehealth visits in January and February, followed by acute respiratory diseases, flu and pneumonia, urinary tract infections and eye problems. But March this year bucked the trend as joint and soft tissue conditions and hypertension showed up as two of the most common diagnoses for telehealth visits, signaling growing use of virtual care for managing chronic conditions.
The shift away from a concentration on acute care continued into April. However, its roots stretch back before the pandemic as startups and telehealth giants alike looked more into chronic condition management, specialty, complex and high-cost primary care and followup after high-acuity care like surgeries or chemotherapy.