Mental Health vs. Primary Care: How Americans Are Using Telehealth | Health News from the Healthiest Communities
Since the start of the COVID-19 pandemic, many Americans have been receiving health care via telehealth. The question arises: who are the healthcare professionals on the other end of all those video links and phone calls?
According to new evidence from private insurance claims data, the top specialty providing telehealth services nationwide last January was social worker. Given that the most common telehealth service provided by social workers is psychotherapy, this is only one sign of the prevalence of the provision of mental health services through telehealth, as our country continues to struggle with pandemic and its impact on many fronts.
Monthly telehealth follow-up
FAIR Health has been tracking telehealth trends on a monthly basis since January 2020 with the Monthly regional telehealth follow-up. Drawing on our repository of billions of private healthcare claims, the Telehealth Tracker documented the rapid increase in telehealth use during the early months of the pandemic and has tracked the evolution of telehealth since during. The Telehealth Tracker is a free, interactive online map of the four United States Census Areas (Midwest, Northeast, South, and West) that allows the user to view telehealth infographics for a specific month in the United States. whole country or in individual regions. .
The Telehealth Tracker itself evolved as the pandemic continued. During the first year, to study the impact of the COVID-19 pandemic on telehealth, each month of the pandemic year 2020 was compared with the corresponding month of the pre-pandemic year 2019. In 2021, the The focus has shifted to month-to-month rather than year-to-year.
In 2022, we added new features: the top five specialties of telehealth providers providing telehealth services and the Telehealth Cost Corner, which shows a specific telehealth procedure code and its median costs. Continuing from previous years, the percentage change in telehealth share in medical claim lines, top five telehealth procedure codes and top five telehealth diagnoses. (A claim line is an individual service or procedure listed on an insurance claim.)
As of January 2022, social worker was the provider specialty with the most telehealth services nationally and in all regions except the West. In the West, the primary care physician was the top provider specialty, ahead of the social worker by only a tenth of a percentage point in terms of each specialty’s share of telehealth claim lines. In all other regions and nationally, the primary care physician ranked second behind the social worker.
Nationally, psychiatrists, psychologists and non-physicians in primary care ranked third, fourth and fifth respectively. Although the regions varied in the order of provider specialty, in each region – as in the country as a whole – three of the top five specialties were related to mental health: social worker, psychiatrist and psychologist.
The share of telehealth services provided by social workers varied by region. Nationally, social workers accounted for 28.7% of telehealth request lines. In the Midwest, where their share was highest, they were 32.2%; in the West, where it was lowest, they were 22.4%.
Throughout 2021 and through January 2022, mental health issues were the top telehealth diagnosis category nationally and in all regions. In January, mental health issues accounted for 58.9% of telehealth claim lines nationwide, up from 55% in December 2021. In comparison, mental health issues were also #1 among telehealth diagnoses in 2020, but represented only 44% of telehealth request lines nationwide.
Throughout 2021, generalized anxiety disorder was the top telehealth mental health diagnosis nationally and in most regions, although major depressive disorder was #1 in the West. From May to July 2021 and then from September to October, substance use disorders emerged as one of the top five telehealth diagnoses nationally.
Throughout 2021, the most widely used telehealth procedure code nationally was the code designating an hour of psychotherapy. This code remained the nation’s top telehealth procedure code in January 2022, when it accounted for 23.1% of telehealth claim lines. The top five codes in the country contained two other psychotherapy codes that month: one in fourth place designating 45 minutes of psychotherapy and another in fifth place marking a 30-minute psychotherapy visit with assessment and management.
In three of the four census regions, these three codes were in the top five, with one hour of psychotherapy leading. In the South, however, the top five telehealth codes contained one hour of psychotherapy in the first position and 45 minutes of psychotherapy in the fifth position, but did not include the code for a 30-minute visit.
Services other than mental health
Despite the dominance of mental health services, telehealth also offers a gateway to services and treatment for many other conditions. In January, in addition to mental health conditions, the top five national telehealth diagnosis categories also included acute respiratory illnesses and infections, COVID-19, developmental disabilities, and joint/spinal diseases and problems. soft tissues.
The Telehealth Cost Corner was created to highlight the costs of a different telehealth procedure code each month. For the month of January, the focus was on the code designating the treatment of a speech, language, voice, communication and/or hearing processing disorder. This code is most often used by speech therapists to help correct specific speech or language disorders – usually in young children with language developmental delays and/or autism, but sometimes also in older adults. elderly after stroke or other debilitating events.
Nationally, the median amount charged for this service delivered via telehealth was $129.92, and the median amount allowed was $77.64. A billed amount is the provider’s undiscounted rate, which a patient may have to pay if they are uninsured or go to a provider outside of their plan’s network. An authorized amount is the total fees paid to the provider under an insurance plan. It includes the amount paid by the health insurance plan and the part that the patient pays under the cost-sharing provisions of the plan (for example, a copayment or coinsurance if the patient has paid the deductible).
Costs in January for this type of treatment varied by region. For example, the highest median allowable amount was $88.47 in the Midwest and the lowest was $69.50 in the South.
Telehealth has become a major component of the country’s healthcare system – accounting for 5.4% of all medical claim lines in January 2022 – and data related to provider specialties, diagnoses and procedure codes underscores the fact that many people have used telehealth for mental health. to help.
By documenting these findings, the Monthly regional telehealth follow-up has become a go-to resource for policymakers, researchers, payers, providers, and others seeking to understand and keep pace with the changing healthcare landscape of our nation. We intend to continue to report on changes in telehealth and continue to review changes in its services for mental health issues.