Telehealth payment parity and outpatient service utilization: evidence from privately insured workers.

Zhang Zhang, M Kate Bundorf, Qing Gong, Christopher M Shea, Donna Gilleskie, Sean Y Sylvia
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Abstract

Telehealth was catalyzed by the COVID-19 pandemic and has become a new norm in healthcare. In response to the pandemic, some states passed telehealth payment parity legislation, mandating equal payment rates for telehealth and in-person services. We evaluated the relationship between telehealth payment parity and health service utilization, focusing on insured workers in commercial insurance plans. Using the Merative Commercial Claims and Encounters database from 2019 to 2021, we leverage variation in the timing of policy changes across states using a difference-in-difference approach. Payment parity was significantly associated with increased telehealth visits and total outpatient visits but without a notable rise in in-person visits. Furthermore, payment parity was pronounced in increasing telehealth utilization within self-funded large employer plans, while not significantly associated with telehealth visits among fully insured small employer plans. Our findings underscore the important role of payment parity in increasing telehealth service utilization by incentivizing providers. Future policies should support the sustainable integration of telehealth services, shifting from solely focusing on equal payment rates to adopting value-based reimbursement models that improve equitable healthcare access for all employees in commercial insurance.

远程医疗支付平价和门诊服务利用:来自私人保险工人的证据。
远程医疗受到COVID-19大流行的推动,已成为医疗保健领域的新常态。为应对大流行,一些州通过了远程保健支付平价立法,规定远程保健和现场服务的支付费率相同。我们评估了远程医疗支付平价与医疗服务利用之间的关系,重点关注商业保险计划中的参保工人。利用2019年至2021年的商业索赔和遭遇数据库,我们利用差异中的差异方法利用各州政策变化时间的变化。支付平价与远程医疗访问量和门诊总访问量的增加显著相关,但亲自就诊的人数没有显著增加。此外,在自筹资金的大型雇主计划中,支付平价在提高远程医疗利用率方面很明显,而在完全投保的小型雇主计划中,支付平价与远程医疗就诊没有显著关联。我们的研究结果强调了支付均等的重要作用,通过激励供应商增加远程医疗服务的利用。未来的政策应支持远程保健服务的可持续整合,从仅仅注重平等支付率转向采用基于价值的报销模式,以改善商业保险中所有雇员公平获得医疗保健的机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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