Telehealth claims rose 3,060 percent to October, settling in to over 5 percent of all claims–led by mental health (US)

January 9, 2021 | by

Utilization statistics confirm telehealth’s staggering rise and stabilization. US private insurance telehealth claims data, collected by non-profit FAIR Health in the year October 2019 to October 2020, rose from 0.18 percent of medical claim lines in October 2019 to 5.61 percent in October 2020, a 3,060 percent increase. While the percentages may be low, this tracks with the rise and fall of telehealth visits from February tracked by the last Commonwealth Fund/Phreesia/Harvard University study in October to about 6 percent of medical visits [TTA 29 Oct 20] as well as Epic’s tracking into September [TTA 2 Sept].

According to FAIR’s claim data, telehealth utilization peaked in April at 13 percent, falling in May to 8.69 percent, 6.85 percent in June, and 6 percent in August. This followed the trends reported by both Commonwealth Fund and Epic.

Telehealth visits ticked up September to October, tracking with the rise of positive COVID diagnoses. Telehealth share of medical claim lines rose 10.6 percent nationally, from 5.07 percent in September 2020 to 5.61 percent in October 2020. 

In every month, mental health led the top five diagnoses in the 30-50 percent range, cresting above 51 percent in October. This points to a greater acceptance of telehealth treatment in this specialty, which is positive, but also the distressing rise in CoronaDepression which TTA has been tracking in both the US and UK [TTA 18 Dec 20]

‘Exposure to communicable diseases’ were, up to September, not consistently among the top five reasons for telehealth visits. They re-emerged on the list in October. In other months as well as October, ‘respiratory diseases and infections’ may have been where active COVID was categorized. Other telehealth conditions were ‘joint/soft tissue diseases’ and ‘developmental disorders’. CPT/HCPCS codes are also listed for reference.

To view FAIR Health’s monthly national and regional analyses, go to their Monthly Telehealth Regional Tracker. Release.

News roundup: Milken Institute’s telehealth brief with ATA push on Congress, GoodRx confirms 62% are CoronaDepressed, Johns Hopkins’ COVID mortality risk study and calculators

December 18, 2020 | by

The hot US health tech issue is retaining, consolidating, and adding to the gains that telehealth and remote patient monitoring (RPM) made during the pandemic. The influential Milken Institute (formally the Milken Institute Center for the Future of Aging, Center for Public Health, and FasterCures) has published a short white paper on how best to increase access to telehealth services and support innovation as part of that aim. Their five core recommendations are: 

  1. Permanently lift Medicare location restrictions on telehealth to ensure that older adults can receive a variety of services in their homes and communities, regardless of where they live. (This was also recommended by the Taskforce on Telehealth Policy (TTP) [TTA 18 Sep] which was jointly formed by the ATA, NCQA, and the Alliance for Connected Care.)
  2. Meet the growing need for behavioral health care by addressing barriers to remote care and expanding the availability of telebehavioral  health services.
  3. Increase equitable access to telehealth services through digital technology, literacy programs, and broadband coverage.
  4. Support development and implementation of innovative telehealth and mobile health technology for prevention, well-being, clinical care, and research.
  5. Develop and document clear data sharing standards to support transitions of care across acute, post-acute, and long-term care settings, including care provided in the home and in residential care facilities. 

The consensus is that CMS’ 2021 Physician Fee Schedule post-pandemic (public health emergency=PHE) does not do nearly enough in that it returns–of legal necessity–to the status quo ante geographic restrictions, though it devised a temporary Category 3 to store over 50 telehealth billing codes [TTA 3 Dec]. The American Telemedicine Association (ATA) was joined by multiple organizations on Monday in pressing Congressional leaders to extend national telehealth ‘flexibilities’ as part of the $1.4 trillion omnibus spending deal that is needed to avoid a government shutdown on Friday (yes, this Friday) at midnight. The organizations joining the ATA on the letter to Congress are the Alliance for Connected Care, College of Healthcare Information Management Executives, Connected Health Initiative, eHealth Initiative, Health Innovation Alliance, HIMSS, and PCHAlliance. ATA release.

We are shocked, shocked that CoronaDepression worsens in those already suffering. Prescription discounter GoodRx analyzed prescription fill trends for anxiety and depression meds and found that they reached an all-time high in 2020–9.5 percent higher than the previous high in 2016. It peaked in April as the pandemic was underway, and possibly reflected some stockpiling.

Of their sample of 1,042 individuals diagnosed with anxiety and depression prior to the pandemic:

  • 22 percent responded that their symptoms were “much worse”
  • 40 percent said they were “worse”
  • 28 percent stated that symptoms were the “same”
  • a surprising 10 percent said symptoms were “better” or “much better” 

One of the main factors in that 62 percent reporting worse/much worse was the length of quarantine. “Those who reported quarantining due to COVID-19 were far more likely to report “worse” or “much worse” symptoms compared to those who did not quarantine. Over 70% of those who reported quarantining for more than one week said their depression and/or anxiety symptoms were “worse” or “much worse.” Loss of job and income, plus COVID-related events affecting friends and family, were also key in worsening symptoms. Many also had difficulty reaching their doctors/therapists and renewing medication. The study was conducted 1-10 November. GoodRx study

More depressing news (sic) of mental health challenges to older adults in the Isolation Age: The Future of Remote Care Technology, Lockdown Loneliness feared more than COVID, and the PLOS One study.

But cheer up and carry on, your COVID mortality risk may not be as bad as you think. A team of researchers at the Johns Hopkins Bloomberg School of Public Health created a COVID mortality risk calculator, based on algorithms calculating factors such as age, gender, sociodemographic factors, location, and a variety of different health conditions. Risk scores are grouped into five categories from lower than average/close to average to high.  While primarily for public health authorities to prioritize populations for vaccination, uninfected individuals can use it to determine their personal risk of future infection and complications after infection. It’s easy to use and your results may surprise you. There is also an interactive US map of the risk level of major cities, counties, and states. The study is published in a paper that appears in the journal Nature Medicine.  Johns Hopkins release, risk calculator