Utilization of Outpatient Telehealth Services in Parity and Nonparity States 2010-2015

Abstract

Background and Introduction: Telehealth is a promising approach to improving healthcare access and quality. While coverage for telehealthcare has expanded, reimbursement remains one of the biggest barriers to provider adoption. Thirty-four states and the District of Columbia have enacted parity legislation requiring private insurance companies to provide some level of reimbursement coverage for telehealth services.

Materials and methods: The purpose of this article is to describe the trends in telehealth utilization from 2010 to 2015 for privately insured patients. Using a nationally representative sample of patient data from the 2010-2015 Truven^® MarketScan Commercial Claims dataset, we examine the change over time in the utilization of outpatient telehealth visits between states enacting parity legislation and those who do not.

Results: We found the 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 29.8% greater than in a nonparity state (p < 0.0001).

Discussion and conclusion: Telehealth remains a small percentage of all outpatient private health insurance claims. Enactment of telehealth parity legislation is related to significant increases in the utilization of telehealth outpatient services. Further expansion of private telehealth insurance coverage may encourage increased utilization of telehealth services. However, telehealth reimbursement coverage varies greatly across parity states. Future examination of the impact of individual state-level policy options on telehealth utilization is warranted.