Reporting Framework for Value Based Care
Learn how a provider's relative performance, or 'value', can be evaluated through three key components in an equation: quality, efficiency, and cost.
Telehealth is the use of electronic information and telecommunication technologies to support remote clinical healthcare, patient and professional health-related education, public health, and health administration. Currently millions of Americans are residing in areas with a shortage of primary healthcare providers and often experience delays to see a provider.[i] Telehealth is believed to improve access to healthcare for patients living in both rural and urban areas and ensure that patients receive the right care at a place and time most accessible to them. In addition, telehealth is also believed to reduce healthcare costs by:
Currently, 31 states and the District of Columbia have parity laws that mandate commercial insurers pay for telehealth services.[ii] Unfortunately, there are barriers to wide adoption of telehealth. For example, Medicare generally still limits coverage and payment for many telehealth services, lagging behind other payers.[iii]
We analyzed one of MedInsight's client’s data for 2010-2017 with over 3.9 million Medicaid, Medicare, and Commercial plan members, to explore the use of telehealth services. We only explored those services recognized by federal and commercial health plans[iv] as billable for telehealth services.
Trends in telehealth use
We analyzed the data to study the utilization of telehealth services over 8 years and its distribution across different age groups and gender (Figure 1, Figure 2 and Figure 3). We observed that:
Figure 1: Trends in telehealth use
Figure 2: Average cost trend
Figure 3: Telehealth use across age groups and gender
Specialty based use of telehealth
Apart from analyzing the telehealth use by patients, we also analyzed the use across provider specialties (Figure 4) for the year 2017.
Figure 4: Telehealth use by specialty
Clinical Classifications Software category based use of telehealth
Instead of analyzing data at the individual diagnosis level, we compared the telehealth use for the year 2017 at the Clinical Classifications Software (CCS) category[v] level, (Figure 5) which provides a method for classifying diagnoses into clinically meaningful categories.
Figure 5: Telehealth use by CCS diagnosis category
Although the analysis was based on limited administrative data, it illustrated that telehealth is a far less expensive option in comparison to the conventional face-to-face visits. Even a one percent shift from face-to-face visits to telehealth can save millions of dollars. However, members, payers, and providers need to start embracing telehealth as effective as any other form of healthcare service delivery method.
[i] Telehealth Programs, Health Resources and Services Administration. Available at: https://www.hrsa.gov/rural-health/telehealth/index.html
[ii] Jamal H. Mahar, MD et al. 2018. Telemedicine: Past, present, and future. Available at: https://www.mdedge.com/ccjm/article/189759/practice-management/Telehealth-past-present-and-future
[iii] American Hospital Association. Fact sheet: Telehealth. Available at: https://www.aha.org/system/files/2019-02/fact-sheet-telehealth-2-4-19.pdf
[iv] United Healthcare, telehealth and telemedicine policy. Policy Number: ADMINISTRATIVE 114.32 T0. April 2019.