Since the start of the pandemic, mental health conditions have remained the top diagnosis seen in telehealth nationwide, recently reaching 61.2% of all virtual care claims.
From August to September 2021, mental health conditions increased in percentage share of all telehealth claims nationally, FAIR Health's Monthly Telehealth Regional Tracker found.
While most virtual physician interactions have returned to lower rates, virtual behavioral health visits have only continued to rise, said Tom Kiesau, senior partner with the Chartis Group.
"There's none of the broader social perception that goes along with the challenges of people seeking mental health care," Kiesau said. "Historically, in a virtual setting, it is protected and private."
In the case of mental health services, telehealth has helped populations overcome stigma, gain easier access and receive more consistent care, said Krista Drobac, executive director of the Alliance for Connected Care.
FAIR Health has used data from privately insured populations, including Medicare Advantage, to gauge how telehealth is evolving each month since May 2020. Data also show that nationwide telehealth utilization, as a percentage of all medical claims, grew by around 2% in August and September, following several months of declined use.
Overall telehealth usage rose to 4.4% of all medical claims in September, as COVID-19 variants and surges slowly began driving patients away from in-person visits. Though virtual care appointments increased in the Midwest and West, they decreased in the Northeast and there was no change in their use in the South.
Reductions in telehealth usage are not inherently bad, Drobac said, as industry experts always expected telehealth levels to fall as patients returned to in-person visits. What matters is the ability to pursue virtual options.
"Our expectation about how much healthcare people will use stays the same," she said. "It's just the mix of how they pursue healthcare that's changing. And that is a good thing."
Across the country, healthcare clients are mostly either passive about telehealth, letting physicians dictate their own offerings, or they are investing in and focusing on the consumer's virtual experience, Kiesau said.
"Some organizations are making a more concerted effort to drive digital access and digital capacity for patients, which is driving up their share of the percentage of virtual interactions," he said.
In August, COVID-19 accounted for between 1.5% and 3.5% of claims in every region except the Northeast, and in September, the virus dropped out of the top five diagnoses seen nationwide in telehealth.
This dip is likely due to the fact that more individuals have been vaccinated and may be experiencing less acute symptoms, Drobac said.
Nationally, developmental disorders climbed from fourth to third place in the top telehealth diagnoses, while substance use disorders became part of the top five ranking in September.
Of the top five telehealth procedure codes ranked by utilization, 30 minute psychotherapy visits, performed with evaluation and management, took fifth place nationwide in September. This procedure displaced talking with one's physician over the phone for five to ten minutes.
At this point in the pandemic, patients are still somewhat hesitant to return to office visits but have a high level of satisfaction with telehealth options, Kiesau said.
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Over time, he said the industry will shift so that healthcare facilities offering the most flexibility in their virtual and in-person services will accumulate more patient volume.
"Consumers ultimately dictate how business is delivered and transformed, based on their demands for convenience and for simplicity," Kiesau said.