Nov. 29, 2018
Dive Brief:
- Annual telehealth visits among the commercially insured increased
by 52% annually from 2005 to 2014 and 261% from 2015 to 2017, according to
a new study published
in JAMA on Tuesday. Visits increased from just 206 in 2005 to roughly
202,300 in 2017, most likely driven by increased payer coverage for
direct-to-consumer telemedicine, the report says.
- Overall, from 2005 to 2017, there were about 383,500 telemedicine
sessions between nearly 217,900 (mostly female and urban-living) patients.
Primary care telemedicine visits grew 36% annually before 2016 and then increased
exponentially to about 126,400 visits in 2017. Use of telehealth
services for mental health grew much more steadily, by almost 60% annually
to about 57,000 visits in 2017.
- The study, which attempts to address the lack of knowledge about
telemedicine adoption nationwide, analyzed de-identified data from more
than 200 million privately insured and Medicare Advantage enrollees in
research group OptumLabs' database.
Dive Insight:
Telemedicine has been heralded by some as a
balm to America's health disparities, a tool to improve access to specialty
care (especially in traditionally underserved areas such as the rural U.S.,
where roughly 20% of the nation's population lives.)
Advocates cite the cost savings for
telehealth initiatives as well. A 2017 report from
the Rural Broadband Association found that such services were associated with
an annual cost savings of $20,841 per U.S. hospital on average. By some
estimates, telemedicine (including remote patient monitoring) could knock $4.3
billion off the country's yearly healthcare bill.
To facilitate adoption, 34 states and the
District of Columbia have passed parity laws to date. These laws require payers
to reimburse in-person health services and telehealth visits at similar rates,
and can help incentivize providers to implement virtual options.
The JAMA study found that patients
implementing telehealth services were on average 38.3 years old. It showed that
63% were female and 83.3% lived in urban areas, suggesting the practice may not
yet be the savior of rural healthcare deficits that some proponents think it
is.
Researchers slotted the information into
three telemedicine visit categories: telemental health (mental health diagnoses
and clinicians), primary care telemedicine (any non-telemental health visit
with clinicians) and a catch-all category of all other specialist visits,
examining trends against state parity laws and county-level physician supply.
Telehealth mental health services were more
popular in counties with a dearth of psychiatrists, the report found, and in
states with more equivalent reimbursement between in-person health services and
telehealth.
However, the study did not find growth of
primary care telemedicine to be associated with primary care physician
availability, suggesting consumers are prioritizing convenience when they turn
to telehealth services instead of making up for lack of doctors in their area.
Despite the growth from 2005 to 2017,
telemedicine use is still relatively uncommon today. Only half of U.S.
hospitals offer some kind of telemedicine service, according to the American
Telemedicine Association.
A 2017 survey found
that 30% of healthcare executives said telehealth was a high priority in their
organization. Industry rigor on the practice has made the area relatively
lucrative — the North American telehealth market is expected to
reach $16.8 billion by 2020.
Challenges to widespread telehealth
adoption remain. Telemedicine success varies depending
on where and how it's used, according to the Agency for Healthcare Research and
Quality. Determining telehealth's ROI is elusive in
most cases, and concerns about overpayment for telehealth reimbursement persist.
https://www.healthcaredive.com/news/telemedicine-use-among-commercially-insured-skyrocketed-since-2005/543066/
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