Telemedicine Services Provided to Medicare Beneficiaries by Otolaryngologists in 2020

Abstract

Telemedicine utilization among otolaryngologists was rare prior to the COVID-19 pandemic. We sought to understand rates of telemedicine utilization by otolaryngologists amid unprecedented changes in care delivery during the pandemic. Using Medicare Physician/Supplier Procedure Summary data, we performed a retrospective cross-sectional analysis of telemedicine services provided to Medicare beneficiaries by otolaryngologists in 2020. The total number of services and amount of reimbursement received by otolaryngologists for telemedical care increased by 52,989% and 73,147% in 2020 relative to 2019: 139,094 vs 262 services and $9.9 million vs $13,536, respectively. The mean telemedicine revenue per otolaryngologist offset only 8.8% ($9304.69) of losses from the reduction in mean in-person revenue between 2019 and 2020. Further research will be necessary to inform successful adoption of telemedicine within our field amid the ongoing COVID-19 pandemic.

Patient and Visit Characteristics Associated With Otolaryngology Telemedicine Care

“…Telemedicine use in otolaryngology increased substantially in response to the COVID-19 pandemic. 1 Prior literature at 1 institution noted found that patient participation with telemedicine at the peak of the pandemic, from March to May 2020, was associated with demographics such as age, sex, insurance, marital status, and income. 10 Specifically, patients who identified as male, were older in age, and had a lower median household income were less likely to use virtual care.…”

“…In the wake of the COVID-19 pandemic, otolaryngologists significantly increased the delivery of telemedicine services to support patient access to care while preventing illness transmission. [1][2][3] Studies in multiple specialties have demonstrated that despite expansion of telehealth, marginalized populations have been noted to use these services at a lower rate, raising concern for inequities in access. [4][5][6] For example, a prior study in ophthalmology noted patients who identified as male, Black, non-English speaking, older, or with an education level of high school or less were less likely to receive telemedicine care.…”

Methods of Reimbursement for Telemedicine Services: A Scoping Review

“…In most of these studies, part of the telemedicine services was reimbursed by various insurances. In more than half of the studies, Medicare insurance was used to reimburse telemedicine services (4,16,22,23,25,26,27,29,30,35,36,(38)(39)(40)(41)(42)46). Medicare is funded by the government and regulated at the federal level (47).…”

“…In 18 studies (4,16,22,24,25,26,29,30,32,33,35,38,39,42,43,44,45,46) various insurances did not differentiate between the reimbursement of telemedicine services and face-to-face (traditional) visits. Also, among the studies related to the reimbursement of telemedicine services by private insurances (n = 13), only in 4 studies the rate of reimbursement of private insurances for telemedicine services was higher compared with other insurances (38,39,43,46).…”