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Oral Presentation

(V2-02) Utilization of Outpatient Telehealth Services in Parity and Non-Parity States

Sunday, April 23
11:50 AM - 12:09 PM
Location: W230 BC

Objectives
1. Describe the development in state-level telehealth parity legislation for privately insured patients.
2. Describe the trends in outpatient utilization for privately insured telehealth services.
3. Examine the change over time in the utilization of outpatient telehealth visits between states enacting parity legislation and those who do not.

Methods
We use a quasi-experimental study design to examine outpatient telehealth visits in parity states and a comparison group of non-parity states. This study utilizes data from the 2010-2014 Truven® MarketScan Commercial Claims dataset, a nationally representative sample of patient-level claims data on utilization, expenditures, and prescriptions drugs. The dataset includes a convenience sample of private insurance claims from approximately 100 payers.
 
Our outcome of interest is the occurrence of a patient-level telehealth claim. We define a telehealth visit as one using the GT modifier on the CPT code. For each outpatient claim, we coded telehealth=1 if the GT modifier occurred and 0 for in-person visits. Due to the unequal volume of non-telehealth visits in the dataset, we matched a 1% sample based on visit types. We examined the effect of parity-state status on the likelihood of having an outpatient telehealth claim using logistic regression, controlling for year.

Results
The number of telehealth outpatient claims has more than doubled in the US between 2010 (5498) and 2014 (11,410). In general, the utilization of telehealth is increasing over time. The odds of having an outpatient telehealth visit increased by 21.9% by year (p < 0.0001) across all states. In addition, those states with parity laws saw significant increases in the number of outpatient telehealth visits. Controlling for year, the odds of receiving a telehealth visit in a parity state were 33% greater than in a non-parity states (p < 0.0001).


Conclusion
Telehealth is a promising approach to improving healthcare access and quality. Reimbursement remains one of the biggest barriers to adoption of telemedicine services, as over one-half of Americans are covered through private insurance. Adopting reimbursement policy interventions may be one approach to improving access. Telehealth parity laws require private insurance companies to reimburse telemedicine services similar to in-person healthcare visits. Since 1995, thirty-one states have enacted telehealth parity legislation, with the number more than doubling in the last four years.

Utilization of telehealth in the outpatient setting has significantly increased between 2010-2014. However, telehealth remains a small percentage of all outpatient private health insurance claims. Enactment of telehealth parity legislature is related to significant increases in the utilization of telehealth outpatient services. Further expansion of private telehealth insurance coverage would encourage increased utilization of telehealth.

Jillian Harvey

Assistant Professor
Medical University of South Carolina

Jillian Harvey is an Assistant Professor in Healthcare Leadership and Management at the Medical University of South Carolina. She received a Master of Public Health from Oregon State University and a PhD in Health Policy and Administration from the Pennsylvania State University. Her experience includes program evaluation, healthcare quality improvement, and mixed methods research approaches. Her current research focuses on evaluating the development and spread of quality improvement interventions/models and the relationship to quality outcomes.

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Mark Lyles

Chief Affiliations and Business Transformation Officer
Medical University of South Carolina

Dr. Mark Lyles is an Associate Professor and the Chief Affiliations and Business Transformation Officer for the Medical University of South Carolina.

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Kit Simpson

Professor
Medical University of South Carolina

Dr. Simpson is a health services researcher with more than 25 years of experience in comparative effectiveness studies and economic evaluations of interventions to improve health outcomes, quality of life and cost of care for patients with complex chronic conditions who reside in disenfranchised communities

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James Mcelligott

Medical Director for Telehealth
Medical University of South Carolina

James T. McElligott, M.D., MSCR, is the Medical Director for Telehealth at the Medical University of South Carolina (MUSC) and an Assistant Professor in the Division of General Pediatrics at MUSC Children’s Hospital.

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Shawn Valenta

Director of Telehealth
MUSC Health

Shawn Valenta is the Director of Telehealth at the Medical University of South Carolina (MUSC Health) in Charleston, South Carolina. With over 15 years of clinical and health care leadership experience, Shawn oversees the strategic initiatives and operations of the MUSC Center for Telehealth.

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(V2-02) Utilization of Outpatient Telehealth Services in Parity and Non-Parity States



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