FAIR Health Presents on Telehealth to FedTel

January 16, 2020

On January 9, FAIR Health President Robin Gelburd and Chief Information Officer Ali Russo addressed FedTel, a federal telehealth workgroup run by the Office for the Advancement of Telehealth, Federal Office of Rural Health Policy, Health Resources & Services Administration. FedTel includes representation from agencies and departments across the US government. Speaking at one of FedTel’s bimonthly web meetings, Ms. Gelburd and Ms. Russo delivered a presentation entitled “FAIR Health Data: A Multilayered Analysis of Telehealth.”

In their presentation, Ms. Gelburd and Ms. Russo examined telehealth at the state and national levels, looked at in-person visits after a telehealth visit and shared insights into telehealth costs.

Analyzing Telehealth at the State Level
Ms. Gelburd and Ms. Russo showed telehealth data for four states—Alaska, Arizona, Texas and Oregon—noting that FAIR Health’s data enable geographical specificity in cost and utilization analyses, providing insight into 493 distinct geozips nationwide. (A geozip is a geographical region that tends to track with the first three digits of a zip code.)

Alaska experienced a 432 percent increase in telehealth usage from 2014 to 2018; nationally, the increase was 634 percent. By far the most common Alaskan telehealth diagnosis was mental health reasons, at 59.48 percent of claim lines, compared with 35 percent nationally. The 0-18 age group accounted for 32.7 percent of telehealth claim lines.

By contrast, Arizona experienced only an 86 percent rise in telehealth usage from 2011 to 2018, contrasting with the national rise of 884 percent in the same period. As in Alaska, mental health reasons were the most common diagnosis (39.02 percent of claim lines).

Further delving into telehealth at the state level, the presenters showed that in Texas telehealth usage increased 1,020 percent from 2014 to 2018. Unlike in Alaska and Arizona, in Texas acute respiratory infections were the most common telehealth diagnosis, accounting for 34.3 percent of claim lines. The 23-40 age group accounted for the greatest percentage of claim lines (41.4 percent) in Texas, while nationally the 41-60 age group represented the largest percentage (35.1 percent).

In Oregon, the increase in telehealth usage from 2012 to 2018 was similar to the national increase (1,217 percent and 1,300 percent, respectively).

The National View
Presenting insights into telehealth at the national level, Ms. Gelburd and Ms. Russo noted that provider-to-patient, non-hospital-based telehealth increased nationally more than any other type of telehealth from 2014 to 2018. During those years, usage of this type of telehealth rose more in urban than in rural locales.

Usage of all types of telehealth nationally was greatest in the 31-40 age group (20.6 percent of claim lines). In second and third place, respectively, were the age groups 31-40 (19.8 percent) and 41-50 (19.1 percent). Usage by females was substantially greater than by males (65 percent versus 35 percent).

In-Person Visits after Telehealth
Ms. Gelburd and Ms. Russo revealed that the top diagnosis with an in-person follow-up visit within 15 days of a provider-to-patient, non-hospital-based telehealth visit for the same or similar diagnosis in 2018 was heart failure, followed by malignant neoplasms of breast and alcohol-related disorders. The telehealth diagnosis with the lowest rate of in-person follow-up visits was encounter for contraceptive management.

Telehealth Costs
Ms. Gelburd and Ms. Russo examined costs for specific procedures in different venues. They showed that the median charge amount for CPT^®1 90837, 60-minute psychotherapy visit, was similar for an office visit and a telehealth visit ($157 and $150, respectively). The discrepancy was greater for CPT 99213, 15-minute established patient office visit, with a median charge amount of $138 for an office visit and $75 for a telehealth visit.

^{1. CPT © 2019 American Medical Association (AMA). All rights reserved.}