The Role of Telehealth Payment Parity on Recommended Care and Emergency Department Service Utilization Among Workers With Chronic Conditions.

Abstract

Background and objective: State-level telehealth payment parity, requiring equal payment rates for telehealth and in-person visits, played an important role in ensuring access to telehealth services. The objective of our study is to evaluate how improved access, driven by telehealth payment parity, affected the utilization of disease-specific recommended care management services and emergency department (ED) services among insured patients with chronic conditions.

Research design: We adopted a 2-way fixed-effect difference-in-differences approach using the Merative Commercial Claims and Encounters database from 2019 to 2021.

Subjects: We focused on insured workers aged 19-64 with pre-existing mental health disorders or cardiometabolic risks (CMRs).

Measures: Outcomes include psychotherapy for mental health disorders, preventive care counseling for CMRs, and ED visits.

Results: Telehealth payment parity was associated with a significant increase in the number of psychotherapy visits and tele-psychotherapy by 0.221 visits (95% CI: 0.050-0.391) and 0.411 visits (95% CI: 0.003-0.818) per patient per quarter, respectively. The regulation significantly reduced E.D. visits among individuals with mental health disorders by 0.003 visits (95% CI: -0.007 to 0.000) per quarter, a 25% relative decrease compared with the control at preperiod. However, payment parity was not statistically associated with increasing preventive care visits and lowering ED visits among individuals with CMRs.

Conclusion: Telehealth payment parity has effectively promoted the adoption of psychotherapy and reduced ED visits among insured workers with mental health disorders. However, it has not significantly improved the uptake of preventive care counseling for individuals with CMRs.