Overview

The Telehealth Services Analysis provides stakeholders with information to understand telehealth services prior to the onset of COVID-19, and the impact the pandemic has had on telehealth service use since March 2020. This report is updated regularly to enable users to track trends in telehealth services over time and the impact on cost and utilization. Please contact us at info@civhc.org for questions.

Insights

  • Utilization:
    • Use of telehealth services hit a peak in April 2020, but slowly declined between May and July 2020 across all payer types.
    • In spite of decreases from May to July, use of telehealth in July 2020 was still significant and represented an increase of 1900% over February 2020 utilization.
  • Payer Variation:
    • From March to July 2020, Medicaid patients used telehealth services the most (2,929 visits/1,000 members) and Medicaid paid the most for those services ($30 Per Member Per Month), followed by commercially insured patients (1,205 visits/1,000 members and $9 PMPM) and Medicare Advantage patients (2,304 visits/1,000 members and $15 PMPM).
  • Diagnoses:
    • Mental health conditions remain the most frequent diagnosis for telehealth services and increased from approximately 30% pre-COVID to a little over 50% of all visits between March and July 2020.
    • With the addition of May-July data, respiratory conditions are no longer in the top four diagnoses for telehealth services. Endocrine/nutritional conditions (7%) are now in the top four in addition to musculoskeletal (6%) and nervous system conditions (6%).
  • Provider Type:
    • Behavioral Health Providers supplied the most services (35%) from March to July 2020, followed by Primary Care Providers (22%), Federally Qualified Health Centers/Rural Health Clinics (6%) and Home Health (5%) providers.
    • Total visits with Behavioral Health Providers have fallen since the initial spike in April 2020 for Medicaid patients, but have increased for both commercially insured and Medicare Advantage patients. Even with Medicaid decreases, visits with Behavioral Health providers in July 2020 (1,009 visits/1,000 members) were much higher than in February 2020 (55 visits/1,000 members).
  • Service Types:
    • Established Patient Office Visits remain the most common service offered during the COVID pandemic followed by Psychiatric Services and Procedures.
  • Geographic Variation:
    • In general, utilization of telehealth services between March and July 2020 was highest in urban counties, while many rural counties had half the number of visits than their urban counterparts.

Considerations

  • When selecting “All” payers, data for 2020 should be viewed with caution because:
    • Medicare Fee-for-Service is only available through December 31, 2019 and is not included in 2020 data, and
    • Commercial and Medicaid claims for June and July 2020 reflect approximately 95% of services provided. Claims for some services incurred during these months have not yet been submitted to the CO APCD.
  • This analysis includes the majority of insured lives in Colorado, but does not include all self-insured employer covered lives, or federal health insurance programs such as the Veterans Administration, Tricare, and Indian Health Services.
  • View the full methodology document for more details on telehealth and telemedicine service categories provided.

Telehealth Overview and Trends

Telehealth Services Detail