Telehealth Usage Climbs While Payment Changes Threaten Care

Despite conflicting market forces at play, the popularity of telehealth continues to spread.

According to the latest numbers from FAIR Health’s Monthly Telehealth Regional Tracker, overall telehealth utilization ticked upward in April, while some regions of the country pulled back.

Nationally, telehealth claim lines rose from 4.73 percent in March to 4.86 percent in April, marking a 2.7 percent increase, according to the independent nonprofit’s monthly telehealth tracker, which pulls data from the commercially insured population, excluding Medicare Fee-for-Service, Medicare Advantage, and Medicaid.

The South saw the biggest bump in utilization at more than 7 percent, while other regions started pulling back. Specifically, 

• The Midwest saw a 0.4 percent drop.
• Use in the Northeast fell 3 percent.
• And the West saw a 3.3% decrease in telehealth claims.

Mental Health Diagnoses Remain Static

The claims data showed no change in the rankings of the top five mental health diagnoses between March and April.

Consistently, the top five reported mental health diagnoses include:

1. Generalized anxiety disorder.
2. Major depressive disorder.
3. Adjustment disorders.
4. Attention-deficit/hyperactivity disorder.
5. Post-traumatic stress disorder.

All told, generalized anxiety disorder and major depressive disorder accounted for more than half of mental health telehealth claim lines nationally and in every region during both months.

Specialties See Changes

The national rankings of the top five telehealth provider specialties saw some changes over the same time frame.

Family practice fell from second to fourth position, while psychiatry and psychiatric nurses rose to second and third positions, respectively. The rankings of the top five telehealth provider specialties remained unchanged in every region.

Social workers hung on to the top spot nationally and across all regions.

Cost Sharing Threatens Future Telehealth Access

The utilization update comes on the heels of a JAMA Network study that underscored a sharp dropoff in the use of telemental health services when cost sharing comes back into play. The findings stoke concerns about continued access to mental health care.

Conducted by researchers examining data from a national telehealth provider, the study focused on the period following the COVID-19 pandemic when regulatory changes allowed telehealth visits to be excluded from deductibles in high-deductible health plans.

The exemption, which Congress extended through the end of 2024, remains under legislative review. But hard data remained elusive – until now. This research project looked at telehealth usage from two client groups — one that reintroduced cost sharing in mid-2021 and one that continued offering telehealth services without additional patient costs.

Critical findings show that patients who had to pay out-of-pocket costs for telemental health visits significantly scaled back their usage. Specifically, the reintroduction of cost-sharing led to 1.5 fewer visits per patient and an 11.7 percent drop in the number of patients continuing their mental health care.

These results suggest that the planned expiration of the cost-sharing exemption in 2025 could lead to decreased access to essential mental health services.

The study’s authors note that the decreased use of telemental health services could negatively impact mental health outcomes, even after the pandemic showed us just how vital accessible mental health care is. The findings align with existing research indicating that patient cost-sharing tends to reduce both necessary and discretionary healthcare services.

Researchers argue that policies that minimize financial barriers to both in-person and telehealth mental health services would help ensure that more people can maintain their mental health care uninterrupted.

Further Reading

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How Olympic Gymnasts Rely On Mental Rituals to Reach New Heights

Why FDA Panel Rejected MDMA for PTSD Treatment