In May, Telehealth Utilization Decreased Nationally and in Every Region but the West, Where It Increased
Mental Health Conditions Continued to Rise as a Percentage of Telehealth Claim Lines Nationally and in Every Region
The Age Group 31-40 Accounted for the Largest Share of Telehealth Claim Lines Nationally and in Every Region
NEW YORK, Aug. 14, 2024 /PRNewswire/ -- In May 2024, telehealth utilization decreased nationally and in every region but the West, according to FAIR Health's Monthly Telehealth Regional Tracker. Nationally, telehealth claim lines fell from 4.86 percent of medical claim lines in April to 4.82 percent in May, a decrease of 0.8 percent.1 In the West, by contrast, telehealth claim lines rose from 6.31 percent to 6.52 percent, an increase of 3.3 percent. In the Northeast, the telehealth share of claim lines fell 0.7 percent; in the Midwest, it fell 0.4 percent; and in the South, it fell 0.1 percent. The data represent the commercially insured population, excluding Medicare Fee-for-Service, Medicare Advantage and Medicaid.
Diagnostic Categories
In May as in April 2024, mental health conditions remained the top-ranking telehealth diagnostic category, with 68.6 percent of total telehealth claim lines nationally in May, and rose in percent of telehealth claim lines nationally and in every region.
From April to May, acute respiratory diseases and infections fell out of the top five telehealth diagnostic categories in the Northeast and West, replaced in the fifth position by endocrine and metabolic disorders in the Northeast and by diabetes mellitus in the West. Acute respiratory diseases and infections fell from second to third position in the South and remained in fifth position in the Midwest. This diagnostic category remained in second position nationally, but fell in percent of telehealth claim lines.
Mental Health Diagnoses
There was no change in the rankings of the top five telehealth mental health diagnoses from April to May 2024. Nationally and in every region, the top five mental health diagnoses in both months were: generalized anxiety disorder, major depressive disorder, adjustment disorders, attention-deficit/hyperactivity disorder and post-traumatic stress disorder. Together, generalized anxiety disorder and major depressive disorder accounted for more than 50 percent of mental health telehealth claim lines nationally and in every region in both months.
Specialties
From April to May 2024, family practice rose from fourth to third position nationally in the rankings of the top five telehealth provider specialties. In the Midwest, psychiatric nurse rose from fourth to third position, while family practice joined the list in fifth position, displacing psychiatry. In the West, psychiatric nurse rose from fourth to third position.
Social worker remained in the first position nationally and in all regions.
Age
From April to May 2024, the largest share of telehealth claim lines in the Midwest and Northeast shifted from the age group 19-30 to the age group 31-40. In both months, the age group 31-40 was also the age group with the largest share nationally and in the South and West. In both months, the age groups 19-30 and 31-40 each accounted for more than 20 percent of telehealth claim lines nationally and in every region.
Costs
Nationally and in every region, the median allowed amount2 for CPT®3 90837 (one-hour psychotherapy) in May 2024 was higher when rendered via telehealth than in an office. Nationally, the median telehealth cost was $117 and the office cost $114. The highest median values for both telehealth ($130) and office ($129) occurred in the Northeast. In the Midwest, the median telehealth cost was $119 and the office cost was $115. In the West, the median telehealth cost was $116 and the office cost $111. In the South, the median telehealth cost was $110 and the office cost $105.
About the Monthly Telehealth Regional Tracker
Launched in May 2020 as a free service, the Monthly Telehealth Regional Tracker uses FAIR Health data to track how telehealth is evolving from month to month. An interactive map of the four US census regions allows the user to view an infographic on telehealth in a specific month in the nation as a whole or in individual regions. Each year, the infographic introduces varied views into telehealth utilization. In this fifth iteration of the Monthly Telehealth Regional Tracker, each infographic shows month-to-month changes in volume of telehealth claim lines; that month's top five diagnostic categories, mental health diagnoses and specialties; age distribution; and the Place of Service Cost Corner, which compares median allowed amounts for a specific procedure provided via telehealth to the same procedure provided in an office.
FAIR Health President Robin Gelburd stated: "We are happy to share these continuing windows into telehealth utilization as this venue of care evolves. This is one of the many ways we pursue our healthcare transparency mission."
For the Monthly Telehealth Regional Tracker, click here.
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About FAIR Health
FAIR Health is a national, independent nonprofit organization that qualifies as a public charity under section 501(c)(3) of the federal tax code. It is dedicated to bringing transparency to healthcare costs and health insurance information through data products, consumer resources and health systems research support. FAIR Health possesses the nation's largest collection of commercial healthcare claims data, which includes over 47 billion claim records and is growing at a rate of over 3 billion claim records a year. FAIR Health licenses its commercial data and data products—including benchmark modules, data visualizations, custom analytics and market indices—to commercial insurers and self-insurers, employers, providers, hospitals and healthcare systems, government agencies, researchers and others. Certified by the Centers for Medicare & Medicaid Services (CMS) as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D, which accounts for a separate collection of over 48 billion claim records; FAIR Health includes among the commercial claims data in its database, data on Medicare Advantage enrollees. FAIR Health can produce insightful analytic reports and data products based on combined Medicare and commercial claims data for government, providers, payors and other authorized users. FAIR Health's systems for processing and storing protected health information have earned HITRUST CSF certification and achieved AICPA SOC 2 Type 2 compliance by meeting the rigorous data security requirements of these standards. As a testament to the reliability and objectivity of FAIR Health data, the data have been incorporated in statutes and regulations around the country and designated as the official, neutral data source for a variety of state health programs, including workers' compensation and personal injury protection (PIP) programs. FAIR Health data serve as an official reference point in support of certain state balance billing laws that protect consumers against bills for surprise out-of-network and emergency services. FAIR Health also uses its database to power a free consumer website available in English and Spanish, which enables consumers to estimate and plan for their healthcare expenditures and offers a rich educational platform on health insurance. An English/Spanish mobile app offers the same educational platform in a concise format and links to the cost estimation tools. The website has been honored by the White House Summit on Smart Disclosure, the Agency for Healthcare Research and Quality (AHRQ), URAC, the eHealthcare Leadership Awards, appPicker, Employee Benefit News and Kiplinger's Personal Finance. For more information on FAIR Health, visit fairhealth.org.
Contact:
Rachel Kent
Executive Director of Communications and Marketing
FAIR Health
646-396-0795
[email protected]
1 A claim line is an individual service or procedure listed on an insurance claim.
2 An allowed amount is the total fee paid to the provider under an insurance plan. It includes the amount that the health plan pays and the part the patient pays under the plan's in-network cost-sharing provisions (e.g., copay or coinsurance if the patient has met the deductible).
3 CPT © 2023 American Medical Association (AMA). All rights reserved.
SOURCE FAIR Health
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