Over 90 Percent of Connecticut Patients Used Telehealth to See Healthcare Providers Whom They Also Saw in Person
NEW YORK, Sept. 7, 2023 /PRNewswire/ — A new study from FAIR Health examines the use of telehealth in Connecticut from 2020 to 2022. The study has been released as a white paper entitled Telehealth in Connecticut: An Analysis of Private Healthcare Claims Focusing on Areas with Greater Minority Populations.
Previous research has left unclear the impact of telehealth on patient results such as number of visits, costs, emergency room (ER) visits and hospitalizations, and how these relate to the racial and ethnic diversity of an area. With generous funding provided by the Connecticut Health Foundation, FAIR Health conducted an observational study, delving into its repository of private healthcare claim records—the largest in the nation—to analyze the Connecticut population overall as well as seven of the most common and well-known health conditions treated via telehealth in the state. Because FAIR Health does not have data on the race or ethnicity of specific patients, data are reported based on the racial and ethnic makeup of geographic areas, not the race or ethnicity of individual patients.
The study examined telehealth use for seven conditions: anxiety and other nonpsychotic mental disorders, mood (affective) disorders, COVID-19, acute upper respiratory infections, hypertensive diseases, diabetes mellitus and substance use disorders.
Among the key findings comparing patients who used telehealth to those who received only in-office medical care, using claim dates of service from March 1, 2020, to September 30, 2022:
- Overall, Connecticut telehealth patients were more likely to have ER visits and hospitalizations than patients who did not use telehealth care, and that likelihood was higher for those who had more ER visits or hospitalizations. It is beyond the scope of this study to determine whether telehealth treatment or differences in the patients who select telehealth care led to the different results.
- Connecticut telehealth patients were almost 15 times as likely as those who did not use telehealth to have more total visits1 than average and over 10 times as likely to have a higher allowed amount2 sum than average.
- Most patients used telehealth to see healthcare providers whom they also saw in person. Overall, 92.5 percent of Connecticut patients sought telehealth care from a provider whom they saw in person either before or after their telehealth visit. Only 7.5 percent of Connecticut patients used a telehealth provider they never saw in person.
- Females used telehealth more than males. Of all Connecticut residents receiving medical care included in the data, 52 percent were female and 48 percent were male. Among telehealth users, however, 59 percent were female and 41 percent were male.
- In most of the eight geozips3 in Connecticut, the share of patients using telehealth was fairly similar to that using all medical services. The two exceptions were geozip 061 (Hartford), which had a lower percentage of patients using telehealth, and geozip 068 (Stamford, Norwalk, Danbury), which had a higher percentage of patients using telehealth.
- For all seven health conditions analyzed in Connecticut, greater racial and ethnic diversity in an area (as measured by a smaller percentage of white people)4 correlated with higher average numbers of ER visits and hospitalizations for both patients who used telehealth and those who did not use it. For six out of seven conditions, the differences among the three different population groupings (geozips that are 26 to 50 percent white, 51 to 75 percent white and 76 to 100 percent white) were statistically significant.
- For two behavioral health conditions, a higher percentage of patients used telehealth rather than using only in-office care, but for the other five conditions studied, more patients were treated without telehealth than with it. The two conditions with higher telehealth use were anxiety and other nonpsychotic mental disorders (71 percent versus 29 percent), and mood (affective) disorders (74 percent versus 26 percent). The other five conditions—COVID-19, acute upper respiratory infections, hypertensive diseases, diabetes mellitus and substance use disorders—had higher percentages of patients associated with in-office care only than with telehealth.
- For all seven conditions analyzed, patients who used telehealth had higher average numbers of ER visits and hospitalizations than those who did not. The difference was particularly pronounced among patients with diabetes mellitus and hypertensive diseases; patients who used telehealth for these conditions had approximately double the average number of ER visits and hospitalizations as patients who did not use telehealth.
- For two behavioral health conditions, higher average overall costs for treatment were associated with patients who used telehealth, while lower average costs were associated with patients who used telehealth for two infectious conditions. For the behavioral health conditions (anxiety and other nonpsychotic mental disorders, and substance use disorders), average total allowed amount per person was higher for patients who used telehealth than those who used only in-office care across each of the eight geozips in Connecticut and across the state as a whole. For two of the other conditions (acute upper respiratory infections and COVID-19), average total allowed amount per person was lower for patients who used telehealth than those who used only in-office care in all eight geozips and statewide. Telehealth for the remaining three conditions varied by geozip and statewide.
- For treatments that included telehealth, substance use disorders were the condition with the highest likelihood of having more visits than the average number of visits. Acute upper respiratory infections were the condition least likely to be associated with more visits than average when treatment included telehealth.
- Visits for patients who used telehealth for anxiety and other nonpsychotic mental disorders were the most likely to have higher-than-average total allowed amounts for all treatment received for that condition. Such patients also had more anxiety-related visits than average, which may indicate greater adherence to treatment. Visits for patients who used telehealth for COVID-19 were the least likely to have higher-than-average total allowed amounts.
It is beyond the scope of this study to determine whether the increased visits, costs, ER visits and hospitalizations generally associated with telehealth in Connecticut in 2020-2022 were necessary or unnecessary, or whether there was a causal relationship between telehealth and the measured results. For example, with behavioral health conditions, a greater number of visits may indicate greater adherence to recommended treatment for those conditions. Similarly, increased visits noted for patients with diabetes and hypertension—both conditions that disproportionately affect people of color—may indicate increased remote monitoring.
FAIR Health President Robin Gelburd stated: “With the generous support of the Connecticut Health Foundation, FAIR Health’s unparalleled data repository has been used to open a window into the utilization of telehealth in Connecticut, particularly as related to differences in treatment in areas with greater minority populations. FAIR Health hopes that this study will be of value to healthcare stakeholders in Connecticut and nationwide, including researchers, payors, providers, policy makers and patients.”
Connecticut Health Foundation’s Vice President of Program Ellen Carter commented: “The importance of telehealth became clear during the height of the COVID-19 pandemic, and data from this time period can provide insight to help us understand how telehealth can improve access to care and patient outcomes. Going forward, it will be valuable to understand how telehealth can reduce barriers to care and what barriers exist to using telehealth among patients who could benefit.”
For the complete study, click here.
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About FAIR Health
FAIR Health is a national, independent nonprofit organization that qualifies as a public charity under section 501(c)(3) of the federal tax code. It is dedicated to bringing transparency to healthcare costs and health insurance information through data products, consumer resources and health systems research support. FAIR Health possesses the nation’s largest collection of private healthcare claims data, which includes over 42 billion claim records and is growing at a rate of over 2 billion claim records a year. FAIR Health licenses its privately billed data and data products—including benchmark modules, data visualizations, custom analytics and market indices—to commercial insurers and self-insurers, employers, providers, hospitals and healthcare systems, government agencies, researchers and others. Certified by the Centers for Medicare & Medicaid Services (CMS) as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D; FAIR Health includes among the private claims data in its database, data on Medicare Advantage enrollees. FAIR Health can produce insightful analytic reports and data products based on combined Medicare and commercial claims data for government, providers, payors and other authorized users. FAIR Health’s systems for processing and storing protected health information have earned HITRUST CSF certification and achieved AICPA SOC 2 Type 2 compliance by meeting the rigorous data security requirements of these standards. As a testament to the reliability and objectivity of FAIR Health data, the data have been incorporated in statutes and regulations around the country and designated as the official, neutral data source for a variety of state health programs, including workers’ compensation and personal injury protection (PIP) programs. FAIR Health data serve as an official reference point in support of certain state balance billing laws that protect consumers against bills for surprise out-of-network and emergency services. FAIR Health also uses its database to power a free consumer website available in English and Spanish, which enables consumers to estimate and plan for their healthcare expenditures and offers a rich educational platform on health insurance. An English/Spanish mobile app offers the same educational platform in a concise format and links to the cost estimation tools. The website has been honored by the White House Summit on Smart Disclosure, the Agency for Healthcare Research and Quality (AHRQ), URAC, the eHealthcare Leadership Awards, appPicker, Employee Benefit News and Kiplinger’s Personal Finance. FAIR Health also is named a top resource for patients in Dr. Elisabeth Rosenthal’s book An American Sickness: How Healthcare Became Big Business and How You Can Take It Back. For more information on FAIR Health, visit fairhealth.org.
1 Total visits include telehealth visits, in-person visits, ER visits and hospitalizations.
2 An allowed amount is the total negotiated, in-network fee paid to the provider under an insurance plan. It includes the amount that the health plan pays and the part the patient pays under the plan’s in-network cost-sharing provisions (e.g., copay or coinsurance if the patient has met the deductible).
3 A geozip is a geographic region typically corresponding to the first three digits of a zip code.
4 The percentage of white residents in an area includes those identified by census data as white, as distinct from Black, Hispanic, Asian and other. The three geographic groupings included in this study are all geozips that are 26 to 50 percent white, 51 to 75 percent white and 76 to 100 percent white. Because no geozip in Connecticut is less than 26 percent white, the proportion 0 to 25 percent white is not included in this study.
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SOURCE FAIR Health