Reimbursements for telehealth services are likely to be lower than non-telehealth services in the United States.
Telehealth technologies promise to increase access to care, particularly in underserved communities. However, little is known about how private payer reimbursements vary between telehealth and non-telehealth services. We use the largest private claims database in the United States provided by the Health Care Cost Institute to identify telehealth claims and compare average reimbursements to non-telehealth claims. We find average reimbursements for telehealth services are significantly lower than those for non-telehealth for seven of the ten most common services. For example, telehealth reimbursements for office visits for evaluation and management of established patients with low complexity were 30% lower than the corresponding non-telehealth service. Reimbursements by clinical diagnosis code also tended to be lower for telehealth than non-telehealth claims. Widespread adoption of telehealth may be hampered by lower reimbursements for telehealth services relative to face-to-face services. This may result in lower incentives for providers to invest in telehealth technologies that do not result in significant cost savings to their practice, even if telehealth improves patient outcomes.
1 College of Public Health, University of Nebraska Medical Center, USA.
Fernando A
FA
Wilson
1 College of Public Health, University of Nebraska Medical Center, USA.
Sankeerth
S
Rampa
1 College of Public Health, University of Nebraska Medical Center, USA.
Kate E
KE
Trout
2 City University of New York Graduate School of Public Health and Health Policy, USA.
Jim P
JP
Stimpson
D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data*; D009819:Office Visits / Q000191:economics; D017216:Telemedicine / Q000191:economics / Q000458:organization & administration*; D014481:United States
Telehealth