Telehealth utilization on the rise nationally
In November, national utilization increased 6.3%, climbing from 4.8% of medical claim lines in October to 5.1% in November.
Photo: Kilito Chan/Getty Images
Telehealth utilization increased nationally and in every U.S. census region in November 2023, according to FAIR Health's Monthly Telehealth Regional Tracker. The widespread increases followed a month of varied changes in October.
In November, national utilization increased 6.3%, climbing from 4.8% of medical claim lines in October to 5.1% in November.
The largest regional increase occurred in the West, where the percentage of medical claim lines increased 7.5%, while in the South the increase was 5.3%. In the Northeast, utilization rose 5.2% and in the Midwest the increase was 2.9%.
The data represents the privately insured population, including Medicare Advantage, and excluding Medicare fee-for-service and Medicaid.
WHAT'S THE IMPACT?
In the South, for the first time, diabetes mellitus joined the top five telehealth diagnoses in November, in fifth place with 1.6% of telehealth claim lines. In that region, encounters for examination dropped out of the top five and hypertension took its place in third position, up from fourth place in October.
Nationally, in November, the top five telehealth diagnoses were the same as in October, though the percentage of claim lines for mental health conditions – the number one diagnosis – dropped from 67.1% to 66.4%. The decrease in percentage for mental health conditions seen on the national level was also evident in all four census regions, though mental health conditions remained in first place everywhere.
Conversely, acute respiratory diseases and infections, which remained in second place nationally and in the South, Northeast and Midwest, increased in its share of claim lines from October to November nationally and in all regions. Nationally, the increase was from 2.9% to 3.7%. In the West, that diagnosis moved up from fourth place in October to third place in November.
In the Midwest and Northeast, COVID-19 re-entered the rankings in fourth place with 1.3% of telehealth claim lines in both regions.
The national top five asynchronous telehealth diagnoses remained the same in November as they were in October, with hypertension still holding the number one position. The percentage of asynchronous telehealth claim lines for that diagnosis continued to decrease nationally, falling from 24.3% in October to 23.3% in November.
Regionally, however, the trends varied. A decrease in the percentage of asynchronous telehealth claim lines associated with hypertension occurred in the South, where it remained ranked in second place, but in the other regions, where hypertension still ranked number one, there were increases.
Asynchronous telehealth claim lines associated with mental health conditions, diabetes mellitus and urinary tract infections – in third, fourth and fifth place, respectively, in the national top five – all showed decreases in November. Acute respiratory diseases and infections, in second place, however, continued an increase begun in September, rising from 15.8% in October to 19.6% in November.
Meanwhile, utilization of audio-only telehealth services increased nationally and in every region. The increase was 5.4% in rural areas and 6.4% in urban areas nationally. Audio-only use rose from 5.6 to 5.9% of telehealth claim lines in rural areas, and from 4.7 to 5% in urban areas. Regionally, urban areas showed a greater increase than rural areas, except in the Northeast.
As in previous months, rural areas showed higher utilization than urban areas nationally and in every region except the South, where the pattern was reversed.
THE LARGER TREND
A stark generation gap has emerged between millennials and baby boomers when it comes to telehealth, with younger patients driving the highest overall satisfaction scores and older patients experiencing significantly lower levels of satisfaction, according to the J.D. Power 2023 U.S. Telehealth Satisfaction Study, published in September.
The satisfaction gap is widest in digital channels and appointment scheduling, suggesting that older telehealth users are having problems using telehealth providers' digital interfaces.
Also in September, Epic Research determined that despite being able to be reimbursed for telehealth services at the higher facility rate for another year, providers are frequently billing for these virtual visits at a lower level-of-service code, a trend that holds true for both primary and specialty care. Telehealth visits are more frequently coded with a lower level-of-service billing code than in-person office visits of the same specialty.
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.
