• Recognize the typical telehealth services and frequencies used by Medicaid beneficiaries in a primarily rural state.
• Analyze the growth of services during the duration of the study.
• Apply the newly acquired information and replicate the study in their own state to gain knowledge regarding telehealth usage and trends.
Study design: This was a retrospective analysis of MO HealthNet (Missouri Medicaid) claims data. We analyzed telehealth usage from 2010 – 2013.
Subjects: All beneficiaries of the MO HealthNet (Missouri Medicaid) that used telehealth services during the study time.
Setting: The study was conducted at the University of Missouri. MO HealthNet claims data was accessed through the MU MO HealthNet Data Project, a collaboration of MO HealthNet, the Center for Health Policy, and the Office of Social and Economic Data Analysis at the University of Missouri. Data was analyzed by project staff and the Missouri Telehealth Network.
Preliminary analysis: The number of patients using telehealth increased five times (from 2,309 to 10,013), as did the number of telehealth visits (from 4,882 to 27,277). The claims amount and types of claims increased significantly as well.
MO HealthNet claims data analysis pointed at a rapid growth of telehealth services in Missouri from 2010 to 2013. There were 2,309 patients with 4,882 telehealth appointments in 2010, but in 2013 this number increased to 10,018 patients with over 27,000 telehealth appointments. The claims amount showed appropriate growth as well, with $168,083 that MO HealthNet reimbursed in 2010 to over $1 million in 2013.
In terms of claims type, outpatient office visits and medication management were the most used codes throughout duration of the study, followed by psychotherapy and diagnostic evaluation.
Interestingly, though, in-patient consultation and in-hospital care appeared on the claims data for the first time in 2012, and continued through 2013. In addition, nursing facility care and emergency department started telehealth services for MO HealthNet patients in 2013.
The results of this analysis indicate that adoption of telehealth services has increased in Missouri during the four years of the study in various settings and by different specialties. This information can assist healthcare administrators and providers in planning the expansion of current telehealth services, but also point to the actual needs. Rural and underserved population has historically struggled with adequate timely and affordable access to healthcare services, and this analysis of Medicaid claims data is necessary in gaining understanding of how that access can be successfully utilized via available telehealth technologies.
One of the main limitations of our study was that data from this analysis is restricted MO HealthNet beneficiaries. Medicare and private insurers' claims were not accessed or analyzed.
Assistant Research Professor
University of Missouri
Mirna Becevic, PhD, MHA, is the Assistant Research Professor, University of Missouri, Department of Dermatology.Dr. Becevic is the lead evaluator for the Show-Me ECHO Project. In addition, she works on other telehealth-related studies at the University of Missouri. She was recently named Top Faculty Achiever at the University of Missouri.
She won numerous national and international awards for her research presentations, posters, and articles.
She served as a member of the board for Region VII Health Equity Council with the US Department of Health and Senior Services from 2011-2013.
Dr. Becevic holds a PhD in Health Informatics, Master’s in Health Administration.
Sr. Program Director
Missouri Telehealth Network
Rachel Mutrux is the director of the Missouri Telehealth Network and has been with MTN since 2002. As director, Rachel is responsible for setting the strategic goals for MTN, managing the day to day operations, working with network partners to coordinate and promote telehealth activities. She has oversight of MTN budgets and grants. Rachel is active in the national telehealth affiliation groups and presents locally, regionally and nationally on MTN projects such as Heartland Telehealth Resource Center, HTRC and Show-Me ECHO . Finally, she works to secure funding for telehealth, advocates for legislative policy and works with outside agencies to promote local, state, federal and international telehealth activities and policies. She has built a strong network of relationships in Missouri with health systems, state organizations, health care providers and administrators, and other telehealth stakeholders.
Missouri Telehealth Network
Danny Myers is the Associate Director for Missouri Telehealth Network. He has been with MTN since November of 2011.
Danny comes to MTN with myriad experience in the healthcare field ranging from Ultrasonographer, clinical educator and practice manager. His main responsibilities with MTN include developing and implementing new projects. He is the main point of contact for new telehealth business projects, especially multi-site installation contracts. He oversees the installation and training processes as well. He is also the Project Manager for the Show-Me ECHO Project.
Danny graduated from Arkansas State University with a Bachelor’s degree in Radiologic Sciences. He also holds two Masters degrees from the University of Missouri – Columbia in Health Sciences and Health Administration. He is currently a PhD Candidate at MU in Learning Technologies.