Exploring Costs Related to Increased Telehealth Use

In a study of more than 36.5 million U.S. individuals, ambulatory contacts decreased by 18% between the 2019 and 2020 March to June period while telehealth use increased from .3% of contacts in 2019 to 23.6% of all contacts in 2020.

Findings of the study suggested a dramatic shift in the adoption of virtual care and has many implications for health services provision during and after COVID-19.

Jonathan Weiner, Dr.PH., and colleagues documented patterns and costs of ambulatory care in the U.S. before the initial stage of the pandemic. They further assessed how patient, practitioner, community, and COVID-19-related factors were associated with telehealth adoption.

Study data came from the Blue Health Intelligence data repository, an independent data and analytics company that is a licensee of the Blue Cross and Blue Shield Association. The data included complete claims files for commercial health plan members continuously enrolled from March 1, 2019 through June 30, 2020. The analysis compared the four-month period of March through June in 2019 and 2020.

The team’s unit of analysis was an ambulatory encounter with a telehealth-eligible service. Encounters were defined as a patient seeing a specific practitioner on a specific date. Telehealth included any service provided on a remote basis, whether via video, telephone, asynchronous or synchronous text or email transmission, or other similar technology.

Demographic characteristics were collected, including age, sex, and zip code of residence from enrollment files. The team analyzed allowed charges to assess healthcare costs.

Overall, 36,568,010 individuals were included. In-person contacts decreased by 37% (from 1.63 to 1.02 contacts per enrollee). When the virtual contacts were added, the overall COVID-19 era patient and practitioner visit rate was 18% lower than in 2019 (1.34 vs 1.64 visits per person). Behavioral health visits were the most likely encounters to take place virtually (46.1% vs 22.1%).

Those living in places with limited social resources were less likely to use telehealth (most vs least, 27.4% vs 19.9% usage rates). Medical care costs decreased 15% between 2019 and 2020 from $358.32 to $306.04 per enrollee per month.

The study, “In-Person and Telehealth Ambulatory Contacts and Costs in a Large US Insured Cohort Before and During the COVID-19 Pandemic,” was published online in JAMA Network Open.