Telehealth Claim Lines Increase 5,680 Percent Nationally from May 2019 to May 2020

From April 2020 to May 2020, However, Telehealth Claim Lines Fall 33 Percent Nationally

Findings from FAIR Health's Monthly Telehealth Regional Tracker Suggest Impact of COVID-19 Pandemic

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Aug 06, 2020, 10:01 ET

NEW YORK, Aug. 6, 2020 /PRNewswire/ -- Telehealth claim lines¹ increased 5,680 percent nationally from 0.15 percent of medical claim lines in May 2019 to 8.69 percent in May 2020, according to new data from FAIR Health's Monthly Telehealth Regional Tracker. Although substantial, that increase was less than the year-to-year increase the previous month, when telehealth claim lines increased 8,336 percent nationally from 0.15 percent of medical claim lines in April 2019 to 13.00 percent in April 2020.The data represent the privately insured population, excluding Medicare and Medicaid.

Against the backdrop of the year-to-year increase, telehealth claim lines fell 33 percent nationally from 13.00 percent of medical claim lines in April 2020 to 8.69 percent in May 2020.

The four US census regions (Midwest, Northeast, South and West) all showed trends similar to the nation as a whole. In each region, there were large percent increases in volume of claim lines from May 2019 to May 2020, but these increases were smaller than the increases from April 2019 to April 2020. In addition, in each region, there was a drop in volume of claim lines from April to May 2020. The biggest drop was in the South, where the decrease from April to May was 40 percent, from 9.81 percent of medical claim lines to 5.87 percent.

Higher telehealth utilization from March to May 2020 by comparison with the same months in 2019 suggests the impact of the COVID-19 pandemic. In March and April, many states prohibited elective procedures and non-emergency medical care when rendered in person, making telehealth an attractive alternative. Many of these prohibitions expired in May as states began to open up, perhaps accounting for the drop in the telehealth share of total medical claim lines that month relative to April. Nevertheless, the pandemic continued and telehealth usage remained high by comparison with 2019.

Other notable findings of the Monthly Telehealth Regional Tracker concern the top five telehealth diagnoses:

Mental health conditions, already the number one telehealth diagnosis nationally and in every region in April 2020, accounted for an even larger share of telehealth claim lines in May 2020. Nationally, this diagnosis increased from 34 percent to 40 percent of telehealth claim lines from April to May 2020. In May 2020, it constituted 40 percent or more of telehealth claim lines in every region but the South, whereas in April 2020 it did so only in the Midwest.
In May 2020, developmental disorders ranked among the top five telehealth diagnoses in all regions and nationally, whereas in April 2020 this diagnosis was in the top five in only one region (the West). In May 2019, it was not in the top five in any region. The COVID-19 pandemic appears to be driving the movement toward more use of telehealth in this area.

Launched in May as a free service, the Monthly Telehealth Regional Tracker uses FAIR Health data to track how telehealth is evolving. An interactive map of the four US census regions allows the user to view an infographic on telehealth in a specific month in each region, or in the nation as a whole. In addition to data on the volume of claim lines and on diagnoses, each infographic includes findings on urban versus rural usage and the top five telehealth procedure codes.

FAIR Health is a national, independent nonprofit organization dedicated to bringing transparency to healthcare costs and health insurance information. FAIR Health President Robin Gelburd stated: "COVID-19 is having a pronounced impact on telehealth, but the specifics of that impact vary from month to month. FAIR Health's Monthly Telehealth Regional Tracker is showing in detail how this venue of care is evolving."

For the Monthly Telehealth Regional Tracker, click here.

¹ A claim line is an individual service or procedure listed on an insurance claim.

About FAIR Health

FAIR Health, a national, independent nonprofit organization that qualifies as a public charity under section 501(c)(3) of the tax code, 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 private healthcare claims data, which includes over 31 billion claim records contributed by payors and administrators who insure or process claims for private insurance plans covering more than 150 million individuals. FAIR Health licenses its privately billed 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; FAIR Health includes among the private 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 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 and an English/Spanish mobile app, which enable consumers to estimate and plan for their healthcare expenditures and offer a rich educational platform on health insurance. 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. FAIR Health also is named a top resource for patients in Dr. Marty Makary's book The Price We Pay: What Broke American Health Care—and How to Fix It and Elisabeth Rosenthal's book An American Sickness: How Healthcare Became Big Business and How You Can Take It Back. For more information on FAIR Health, visit fairhealth.org.

Contact:
Dean Sicoli
Chief Communications Officer
FAIR Health
646-664-1645
[email protected]

SOURCE FAIR Health