Telehealth Use Surges in Rapidly Changing Market

What’s New?

Even though it accounts for only 2.6 percent of overall medical claims, Telehealth usage surged 53 percent between 2016 and 2017 and continues to grow rapidly. This rate of telehealth growth surpassed that of urgent care centers, retail clinics, ambulatory surgery centers and emergency departments.

Culling its database of 28 billion commercial claims, Fair Health conducted research showing that national utilization of alternative places of service continued to grow from 2016 to 2017, but at different rates. Learn more about the key findings in Fair Health’s white paper.

Other highlights include:

• Nationally, private insurance claim lines for telehealth services as a percentage of medical claims grew 1,202 percent from 2012 to 2017, as more states (Texas being the latest) and regions implemented laws facilitating telehealth.
• Patients between 31 and 60 years were most likely to use telehealth services (44 percent, down from 56 percent a year earlier), while 10 percent of telehealth claim lines involved children younger than 10 (up from 4 percent a year earlier).
• Females were more likely than males to use telehealth services in every age group except for children younger than 10.

What It Means

Telehealth’s rapid ascent comes as health care organizations continue to push treatment for lower-acuity conditions to lower-cost settings, which in turn has fueled growth in urgent care centers and retail clinics. Private insurance patients, in particular, appear to be making more regular use of telehealth early on in diagnosing and treating non-life-threatening conditions. The report does not specify why private insurance patients more regularly use telehealth services, but it could be due to factors such as these patients having lower copays for telehealth vs. in-person visits or to expedite being seen by a physician.

Meanwhile, the telehealth landscape continues to evolve rapidly. The top three diagnostic categories associated with telehealth in 2017 — each with 13 percent of claim lines — were injury (e.g., contusions, open wounds), acute respiratory infections and digestive system issues. Neither injury nor digestive system issues had been among the top diagnostic categories in 2016.

Mental health services, which had been the No. 1 diagnostic category for telehealth in 2016 and continues to grow, dropped to fifth in 2017, according to the Fair Health report, accounting for 7 percent of the distribution of claim lines. However, as with other areas of this form of care delivery, there is a vast opportunity to expand telebehavioral health services nationally.

To help hospitals and health systems in this effort, the AHA Center for Health Innovation and the National Quality Forum have partnered to produce a new resource on leveraging telehealth technology to expand access to behavioral health services. The playbook provides actionable strategies, interventions and links as well as other tools and resources. Another AHA Center for Health Innovation resource — “Telehealth: A Path to Virtual Integrated Care” — examines the current state of telehealth growth in hospitals and health systems and ways organizations can build capacity to expand access, improve outcomes and reduce costs.