FAIR Health Study Analyzes Telehealth

August 15, 2019

In July, FAIR Health released a white paper that analyzed telehealth—the remote delivery of clinical care through telecommunications technology—at a new level of detail. Drawing on data from FAIR Health’s repository of more than 29 billion private healthcare claim records, the study revealed, for example, that private insurance claim lines for non-hospital-based provider-to-patient telehealth increased nearly 1,400 percent from 2014 to 2018.

Entitled A Multilayered Analysis of Telehealth: How This Emerging Venue of Care Is Affecting the Healthcare Landscape, the white paper examined different types of telehealth, comparing them nationally and by rural versus urban area, as well as by age and gender. It analyzed the most common telehealth diagnostic categories and, using longitudinal data, studied the diagnoses associated with patients who have an in-person follow-up visit within 15 days of a telehealth visit. The white paper quickly won media attention from outlets such as the Washington Post, Modern Healthcare, STAT, KHN Morning Briefing, Becker’s Hospital Review and Health Data Management. An article by FAIR Health President Robin Gelburd on the white paper’s findings appeared in the American Journal of Managed Care.

The four types of telehealth studied in the white paper were:

  • Provider-to-patient–non-hospital-based telehealth. The provider and the patient communicate via telehealth without relation to a hospital.
  • Provider-to-patient–discharge telehealth. The telehealth visit is a follow-up after the patient is discharged from an inpatient stay in the hospital.
  • Physician-to-patient–emergency department (ED)/inpatient telehealth. The patient is in the hospital, whether in the ED or as an inpatient, communicating via telehealth with a physician.
  • Provider-to-provider telehealth. The telehealth exchange involves consultation between healthcare professionals.

The telehealth white paper expanded on a previous FAIR Health white paper that reported on telehealth and other alternative venues of care, such as urgent care centers and retail clinics. These are some of the new white paper’s key findings:

Rapid Growth
From 2014 to 2018, claim lines for non-hospital-based provider-to-patient telehealth grew 1,393 percent. This was a greater increase than for all other types of telehealth studied and for telehealth overall. Claim lines related to telehealth overall grew 624 percent from 2014 to 2018.

For non-hospital-based provider-to-patient telehealth, the increase in that period was greater in urban than rural areas. Claim lines for that type of telehealth increased 1,227 percent in urban areas, 897 percent in rural areas.

The share of the telehealth distribution held by non-hospital-based provider-to-patient telehealth grew in that period. In 2018, that type of telehealth accounted for 84 percent of all telehealth claim lines, compared with 52 percent in 2014.

Age and Gender
In the period 2014-2018, the age group most associated with telehealth overall was that of individuals age 31-40, who accounted for 21 percent of the distribution of all telehealth claim lines. But most of the claim lines (82 percent) for discharge-related provider-to-patient telehealth were associated with individuals 51 and older.

Sixty-five percent of all telehealth claim lines in the period 2014-2018 were associated with females. But for telehealth visits associated with a hospital discharge, 53 percent of claim lines were submitted for females.

Diagnoses
The top three reasons why individuals sought treatment from a provider via non-hospital-based telehealth, from most to least common, were acute upper respiratory infections, mood (affective) disorders, and anxiety and other nonpsychotic mental disorders.

In 2018, the telehealth diagnosis with the highest rate of patients who had an in-person visit within 15 days of a non-hospital-based provider-to-patient telehealth visit for the same or a very similar diagnosis was heart failure.

FAIR Health President Robin Gelburd commented: “As telehealth continues its rapid growth, we are pleased to use our unparalleled data repository to uncover layers that have been difficult to study. We offer the information in this report for the benefit of all healthcare stakeholders with an interest in the emergence and contours of telehealth.”