Rapid Growth of Telehealth Noted in Second Annual FAIR Health Report

April 12, 2019

From 2016 to 2017, private insurance claim lines for services rendered via telehealth as a percentage of all medical claim lines grew 53 percent nationally—more than any other venue of care studied for that variable in the second annual edition of FH Healthcare Indicators® and the FH Medical Price Index®.

Released in a white paper on April 1, these two resources were developed to assist the full spectrum of healthcare stakeholders by providing clarity in a rapidly changing healthcare environment. Fully updated, the new edition of FH Healthcare Indicators and the FH Medical Price Index has already garnered widespread media attention. It has been covered by STAT, Modern Healthcare and Crain’s New York Business, among others, and discussed in articles by FAIR Health President Robin Gelburd in U.S. News & World Report and the American Journal of Managed Care.

“The first edition of FH Healthcare Indicators and the FH Medical Price Index drew a welcome public response, as stakeholders expressed appreciation for being offered this ‘macro’ view into the nation’s healthcare system,” said Ms. Gelburd. “We hope that this new edition continues to inform decision making throughout the healthcare sector by payors, providers, government officials, policy makers, academic researchers and others.”

Telehealth and Other Venues of Care

FH Healthcare Indicators reveal trends and patterns in the places where patients receive healthcare. Focusing on alternative places of service—retail clinics, urgent care centers, telehealth and ambulatory surgery centers (ASCs)—as well as emergency rooms (ERs), FH Healthcare Indicators evaluate changes in utilization, geographic and demographic factors, diagnoses, procedures and costs.

From 2016 to 2017, by comparison with telehealth’s 53 percent growth rate, national usage of urgent care centers increased 14 percent, of retail clinics 7 percent and of ASCs 6 percent, while that of ERs decreased 2 percent.

Despite the rapid growth in telehealth usage, the extent of that usage is still relatively limited. As measured by the percentage of all medical claim lines attributed nationally in 2017 to use of each of the venues of care above, ERs were in first place, with 2.6 percent. The comparable percentages for the other places of service were 1.2 percent for urgent care centers, 0.91 percent for ASCs, 0.11 percent for telehealth and 0.033 percent for retail clinics.

The number one diagnostic category for telehealth had been mental health reasons in 2016, but that category dropped to number five in 2017, at seven percent of claim line distribution. The more common uses of telehealth had expanded to include other types of diagnoses. The top three diagnostic categories associated with telehealth in 2017, each with 13 percent of claim lines, were injury, acute respiratory infections and digestive system issues. Neither injury nor digestive system issues had been among the top diagnostic categories in 2016.

FH Medical Price Index

The FH Medical Price Index takes a different approach from FH Healthcare Indicators, reporting shifts in costs and facilitating useful comparisons among medical prices in six procedure categories: professional evaluation and management (E&M), hospital E&M, medicine, surgery, pathology and laboratory, and radiology. The reports reflect professional fees and related costs, not facility fees.

In the first edition, the FH Medical Price Index presented an overview of median procedure charges and median imputed allowed amounts from May 2012 to May 2017. The new edition extends the indices to November 2018. Of the six categories, hospital E&Ms had the greatest percent increase in billed charge amount index for the period November 2017 to November 2018—seven percent. Hospital E&Ms and radiology had the greatest percent increase in allowed amount indices in that period, both seven percent, while the radiology charge amount index grew six percent.

FAIR Health also makes available customized indicators and indices that offer specific data subsets (e.g., based on clinical category, geographic region or time period) of particular interest to stakeholders. Contact FAIR Health at info@fairhealth.org or 855-301-3247, Monday through Friday, 9 am to 6 pm ET, to learn more about such opportunities.

On Tuesday, May 14, 2019, from 2 to 3 pm ET, Ms. Gelburd will host a free webcast on the new edition of FH Healthcare Indicators and the FH Medical Price Index. Click here to register.