Report: Telehealth visits in Colorado were on the rise before COVID-19

The Center for Improving Value in Health Care (CIVHC) recently released a new report using data from the Colorado All Payer Claims Database (CO APCD) showing that the use of telehealth services in Colorado was on the rise before the onset of the COVID-19 pandemic.

The data also reveals how telehealth use and cost differ by health insurance payer type and type of telehealth service.

According to CIVHC, telehealth utilization per 1,000 members increased from 57 to 75.9 (33%) for commercial, 28.9 to 55.1 (91%) for Medicaid, and 125.7 to 142 (13%) for Medicare Advantage members from January 2018 to February 2020. In January 2020 alone, 19,000 telehealth visits were recorded in Colorado.

 

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Between January 2018 and February 2020, $31 million in payments to providers were made in relation to over 390,000 telehealth services provided to Coloradans.

Looking at demographic utilization, females use telehealth services more often than males (64% compared to 36%), and young adults aged 18-44 use telehealth services more than other age groups.

Mental health conditions led the way as the most frequent reason telehealth was utilized (33%) followed by respiratory conditions (12%) and counseling (7%).

Behavioral health providers have continue to serve more and more patients via telehealth, said CIVHC: “Between January 2018 and February 2020, commercially insured patients increased their use of telehealth with behavioral health providers the most (83%), followed by Medicaid patients (56%) and Medicare Advantage patients (15%).”

As telephone serves remain the most commonly used form of teleheath services, CIVHC pointed to more expansive reimbursement policies as a factor to keep in mind when looking at rising utlization rates:

Primary care providers have historically provided the most telehealth, followed by behavioral health providers. Telephone services are the most commonly provided telehealth offering followed by established patient office visits and transitions of care services offered remotely. It is important to note when viewing the report that telephone services for established patients were reimbursed by commercial and Medicare Advantage plans prior to 2020, but were not reimbursed by Medicare Fee-for-service and Medicaid until April and March 2020, respectively.

Looking at geography, CIVHC found that several rural counties have higher per person telehealth utilization rates compared to their urban counterparts. Alamosa county has the state’s highest overall telehealth utilization rates – a jarring 93% of which were for mental health conditions. Rural counties are not a monolith, however, as Some rural counties, however, have very low telehealth rates.

Rather than a lack of need, CIVHC postulated that this could be indicative of barriers to care, such as insufficient access to broadband services and technology.