Telehealth claims dipped in May, but still up 5,680% from year ago: Fair Health

By | August 9, 2020

Dive Brief:

  • The volume of telehealth-related medical claims in May was not as high as April, but still vastly outpaces a year ago, according to insurance claims data from nonprofit Fair Health. Altogether, telehealth-related care comprised 8.7% of private claims, compared to 0.15% in May 2019 – an increase of 5,680%. That compares to 13% of all claims in April of this year, a drop of about one-third.  

  • Mental health comprised almost 40% of all diagnoses in May, up from 38.4% in May of last year and 34.1% in April 2020. Despite the current COVID-19 pandemic, respiratory diseases and infections were not within the top five diagnoses, even though they comprised 17.2% of diagnoses in May 2019.

  • Although the use of telehealth services appears to be ebbing, the data suggest that telehealth will represent a significant share of healthcare services in the U.S. for the foreseeable future.  

Dive Insight:

Use of telehealth services took off like wildfire beginning in March, as much of the U.S. went under shelter-in-place orders in response to the COVID-19 pandemic.

Although the volume of virtual encounters declined in May compared to April, the volumes remain significant, according to Fair’s repository of 31 billion private insurance claims. States began to reopen that month, likely accounting for the pullback in telehealth use.

Telehealth usage trends are also beginning to show that many Americans are under significant psychological distress. Mental health diagnoses were the leading use of mental health services in May, up 12.6% compared to April, Fair found.

Psychotherapy, which was not among the top five telehealth-related healthcare services in May last year, were two of the top five services in May this year.

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The policies of some commercial insurers also appear to be promoting mental health services: 24% of individual health insurers and 10% of the group insurers expanded mental health services delivered through telehealth platforms, according to a new survey by Peterson-KFF.

The boon in virtual care is also scrambling the competitive landscape, evidenced by this week’s news that Teladoc plans to spend some $ 18.5 billion to acquire chronic care management firm Livongo.

Regulatory hurdles to virtual care are also falling. President Donald Trump earlier this week signed an executive order directing his health administration to implement permanent broader telehealth coverage beyond the current health emergency. Following suit, CMS quickly released new rules to put nine new telehealth payment codes on the books.

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