The COVID-19 pandemic has dramatically changed the way we live, work, and receive healthcare. But are these lasting changes? We examine the utilization of telehealth before, during, and after the pandemic to understand if the rise in telehealth was a temporary trend or a fundamental shift in how people expect to access healthcare.
Telehealth's COVID Impact: Commercial Claims Data Analysis
Research
Claims Data
March 28, 2023
One of the most notable pandemic-induced changes was a stark increase in telehealth utilization. Telehealth refers to the use of technology to deliver healthcare services remotely. However as the risk of COVID-19 transmission subsided in 2021, healthcare providers and patients alike began to seek in-person care again. To assess the changes in use of telehealth services between 2019 to 2021, Accorded analyzed the Merative™ MarketScan® Commercial Claims Database1 which contains eligibility and claims data for over 25 million unique members across the US.
In 2021, the number of members using telehealth services for most categories decreased – with the exception of a notable increase for mental health therapy, from 3.7% in 2020 to 4.8% in 2021 (Figure 1). However, the number of members utilizing telehealth continues to be higher than in the pre-pandemic period - possibly signaling this is a lasting shift in utilization patterns.
Figure 1: Percentage of commercial members who had at least one telehealth service.
In 2021, telehealth accounted for 1.7% of the Commercial Total Cost of Care (or $122 of the average annual spend of $6,977 per commercial member). This is a slight increase from 2020 (1.6%), mainly due to the increase in telehealth for mental health therapy (Figure 2).
Figure 2: Percentage of commercial total cost of care attributed to telehealth service.
The data from the Commercial Claims Database clearly shows that the use of telehealth services has not ceased entirely, despite experiencing a minor decrease, in comparison to the height of the COVID-19 pandemic. This suggests that patients are more comfortable with telehealth as a means of accessing care, and in particular, mental health services. With the growing number of novel care models available, we will look to see whether the adoption of telehealth services will continue as we navigate towards a new norm.
Stay tuned for our analysis of CMS Medicare Limited Data Set.
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Technical details of the analysis
- Metrics are on an incurred basis to reflect when services were rendered.
- Members have a full 12 months of membership during each calendar year.
- Dollars are allowed to reflect the true cost of care: what the payer paid + member share of cost (deductible/copays/coinsurance).
The following service categories are defined by the Agency for Healthcare Research and Quality’s HCUP CCS for Services and Procedures v2022.2 using CPT/HCPCS procedure codes:
- Telehealth (includes telephone calls, online communication, remote monitoring and surveillance)
- Consultation, evaluation, and preventative care
- Psychological and psychiatric evaluation and therapy
With the following additional identifiers, if applicable:
- Telehealth Procedure Code Modifiers
- Telehealth Place of Service Codes
How Accorded utilizes claims data
Accorded utilizes Merative™ MarketScan® Commercial Claims Database and Centers for Medicare & Medicaid Services (CMS) Medicare Limited Data Set (LDS) along with claims data of specific populations to provide definitive actuarial analysis of cost of care outcomes. For employers and payers, this is used to evaluate and forecast efficacy of various health programs, and can serve as the basis for risk-based contract terms. For providers and digital health solutions, the analysis is used for benchmarking, financial impact modeling, and more.
1Merative™ MarketScan® Commercial Claims Database provides one of the longest-running and largest collections of proprietary de-identified claims data for privately and publicly insured people in the US.
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