Statistical Analysis of Telehealth Use and Pre- and Postpandemic Insurance Coverage in Selected Health Care Specialties in a Large Health Care System in Arkansas: Comparative Cross-Sectional Study (Preprint)

Abstract

BACKGROUND The COVID-19 pandemic triggered policy changes in 2020 that allowed insurance companies to reimburse telehealth services, which led to increased telehealth usage, especially in rural and medically underserved areas. However, with many emergency rules ending in 2022, patients and providers are concerned about a potential loss of access to these services. To inform reimbursement decisions, our analysis examines telehealth usage in Arkansas from 2020 to 2022, drawing on electronic medical records collected by the University of Arkansas for Medical Sciences Medical Center (UAMSHealth). OBJECTIVE Evaluate the opportunities and challenges in using telehealth as the means of increasing access to healthcare in Arkansas. METHODS We employed statistical tools to compare the number of telehealth and in-person visits for specific specialties, including OB/GYN, Psychiatry, Family Medicine, Gerontology, Internal Medicine, Neurology, and Neurosurgery, and investigated insurance coverage trends for each. Our evaluation also included a procedure to calculate appointment performance metrics such as waiting time and appointment length. RESULTS Our analysis revealed a significant increase in telehealth visits across all specialties from 2020 to 2021. Meanwhile, the total number of in-person visits covered by Medicare and Medicaid decreased between 2020 and 2022 compared to 2019. Psychiatry, OB/GYN, and Family Medicine had the highest number of telehealth visits, with psychiatry telehealth visits showing shorter wait times than in-person appointments. These findings highlight the potential benefits of telehealth in providing access to healthcare, particularly for patients needing psychiatric care. CONCLUSIONS Limiting healthcare access by returning to pre-pandemic regulations could negatively impact Arkansas, where a large population resides in medically underserved and rural areas. However, our analysis indicates that telehealth usage in Arkansas remained stable beyond 2020, with the number of psychiatry telehealth visits continuing to increase in 2021 and 2022. We hope our findings will influence insurance companies and policymakers to consider reimbursement policies not only in Arkansas but also in other regions facing similar healthcare access challenges.