The Impact of Telemedicine Parity Requirements on Telehealth Utilization in the United States During the COVID-19 Pandemic

Lee, Hyunjung; Singh, GK

doi:10.1097/phh.0000000000001722

Cited by 6 publications

(3 citation statements)

References 27 publications

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“…6 Another study demonstrated enrollees in states with private payer telehealth laws were more likely to receive video assessments. 7 However, our study did not find that telehealth coverage laws alone were significantly associated with the number of telehealth visits. Compared with prior studies, our study specifically examined the impact of these laws during the pandemic period, and focused on the laws relevant to hypertension and CVD management.…”

Section: Discussioncontrasting

confidence: 82%

Section: Discussioncontrasting

confidence: 82%

“…For example, two studies found that utilization of telehealth services significantly increased in parity versus non-parity states. 6,7 In addition, studies have shown similar or better clinical outcomes for patients receiving telehealth care compared with in-person care in various clinical settings. 8,9 However, these studies often overlooked the differentiation between "payment parity" and "coverage parity" when investigating the effects of parity.…”

Section: Introductionmentioning

confidence: 99%

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Impact of State Telehealth Parity Laws for Private Payers on Hypertension Management before and during the COVID-19 Pandemic

Zhang,

Lee,

Popoola

et al. 2023

Preprint

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BACKGROUNDTelehealth has emerged as an effective tool for managing common chronic conditions such as hypertension, especially during the COVID-19 pandemic. However, the impact of state telehealth payment and coverage parity laws on hypertension management remains uncertain.METHODSData from the MerativeTMMarketScan® Commercial Claims and Encounters Database from January 1, 2016 to December 31, 2021 were used to construct the study cohort. The sample included non-pregnant individuals aged 25–64 years with hypertension. We reviewed and coded telehealth parity laws related to hypertension management in all 50 states and the District of Columbia, distinguishing between payment parity laws and coverage parity laws. The primary outcomes were antihypertension medication use, measured by the average medication possession ratio (MPR), medication adherence (MPR ≥80%), and average number of days of drug supply. We used a generalized difference-in-difference (DID) design to examine the impact of these laws. Results were presented as marginal effects and 95% confidence intervals (CI).RESULTSAmong 353,220 individuals, states with payment parity laws were significantly linked to increased average MPR by 0.43 percentage point (95% CI: 0.07 - 0.79), and an increase of 0.46 percentage point (95% CI: 0.06 - 0.92) in the probability of medication adherence. Payment parity laws also led to an average increase of 2.14 days (95% CI: 0.11 - 4.17) in antihypertensive drug supply, after controlling for state-fixed effects, year-fixed effects, individual sociodemographic characteristics and state time-varying covariates including unemployment rates, GDP per capita, and poverty rates. In contrast, coverage parity laws were associated with a 2.13-day increase (95% CI: 0.19 - 4.07) in days of drug supply, but did not significantly increase the average MPR or probability of medication adherence. In addition, telehealth payment or coverage parity laws were positively associated with the number of hypertension-related telehealth visits, but this effect did not reach statistical significance. These findings were consistent in sensitivity analyses.CONCLUSIONSState telehealth payment parity laws were significantly associated with greater medication adherence, whereas coverage parity laws were not. With the increasing adoption of telehealth parity laws across states, these findings may support policymakers in understanding potential implications on management of hypertension.Clinical PerspectiveWhat Is New?Telehealth is an effective tool to manage hypertension and state-level telehealth parity laws can influence its application. Prior studies have not clearly differentiated between the impacts of payment parity and coverage parity. Using a quasi-experimental generalized difference-in-differences design, we assessed the effects of telehealth payment parity and coverage parity laws on hypertension management.Our study found that state telehealth payment parity laws were significantly associated with increased hypertension medication adherence, while coverage parity laws were not.What Are the Clinical Implications?The widespread adoption of telehealth payment parity laws may significantly impact hypertension management, during emergencies like the COVID-19 pandemic and beyond.Considering that hypertension impacts approximately half of the adult population, our study provides valuable insights into the potential benefits of telehealth parity laws for private payers in enhancing the management of hypertension.With the increasing adoption of telehealth parity laws across states, integrating telehealth into hypertension management holds significant implications for the evolving U.S. healthcare system in the digital age.

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Section: Discussioncontrasting

confidence: 82%

Section: Discussioncontrasting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

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Impact of State Telehealth Parity Laws for Private Payers on Hypertension Management before and during the COVID-19 Pandemic

Zhang,

Lee,

Popoola

et al. 2023

Preprint

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Associations Between State Policies Facilitating Telehealth and Buprenorphine Episode Initiation and Duration Early in the COVID Pandemic

Stein,

Saloner,

Sheng

et al. 2024

J GEN INTERN MED

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Importance State policies facilitating telehealth implemented early in COVID may support buprenorphine treatment of opioid use disorder. However, little empirical information is available about those policies’ effects. Objective Examine association between state policies that may facilitate telehealth use and buprenorphine treatment. Design, Setting, Participants Retrospective cohort study using 2019–2020 national pharmacy data on dispensed buprenorphine prescriptions. Exposures State policies implemented after March 3, 2020, public health emergency declaration requiring private insurers’ telehealth reimbursement to be commensurate with in-person service reimbursement, authorizing Medicaid reimbursement for audio-only telehealth, allowing physicians to provide cross-state telehealth services, and allowing psychologists to provide cross-state telehealth services. Main Outcomes and Measures (a) Duration of treatment episodes started between March 1 and March 13 in both 2019 and 2020, and (b) daily numbers of new buprenorphine treatment episodes from March 13 through December 31 in each year. Key Results We found little change in the number of new buprenorphine treatment episodes started in 2020 compared to 2019 and an increase in treatment duration of 10.3 days (95%CI 8.3 to 12.2 days) for episodes started in March 2020 before the public health emergency declaration compared to the comparable 2019 period. States implementing a telehealth parity policy in 2020 had 7.3% (95%CI − 13.3% to − 0.4%) fewer new buprenorphine treatment episodes. States joining the psychologist interstate compact in 2020 after the public health emergency declaration had treatment episodes 7.97 days longer (95%CI 0.78 to 15.16) than other states. None of the other policies examined was associated with changes in new treatment episodes or treatment duration. Conclusions and Relevance Policies undertaken during the pandemic we examined were associated with few significant changes in buprenorphine treatment initiation and duration. Findings suggest realizing the benefits of telehealth and other policy changes for buprenorphine may require more extensive implementation and infrastructure support.

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AI-Driven Analysis of Telehealth Effectiveness in Youth Mental Health Services: Insights from SAMHSA Data

Mansoor,

Grindem

2024

Preprint

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Background: The rapid adoption of telehealth services for youth mental health care necessitates a comprehensive evaluation of its effectiveness. This study aimed to analyze the impact of telehealth on youth mental health outcomes using artificial intelligence techniques applied to large-scale public health data. Methods: We conducted an AI-driven analysis of data from the National Survey on Drug Use and Health (NSDUH) and other SAMHSA datasets. Machine learning techniques, including Random Forest models, K-means clustering, and time series analysis, were employed to evaluate telehealth adoption patterns, predictors of effectiveness, and comparative outcomes with traditional in-person care. Natural language processing was used to analyze sentiment in user feedback. Results: Telehealth adoption among youth increased significantly, with usage rising from 2.3 sessions per year in 2019 to 8.7 in 2022. Telehealth showed comparable effectiveness to in-person care for depressive disorders and superior effectiveness for anxiety disorders. Session frequency, age, and prior diagnosis were identified as key predictors of telehealth effectiveness. Four distinct user clusters were identified, with socioeconomic status and home environment strongly associated with positive outcomes. States with favorable reim-bursement policies saw a 15% greater increase in youth telehealth utilization and 7% greater im-provement in mental health outcomes. Conclusions: Telehealth demonstrates significant potential in improving access to and effectiveness of mental health services for youth. However, addressing technological barriers and socioeconomic disparities is crucial to maximize its benefits.

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The Impact of Telemedicine Parity Requirements on Telehealth Utilization in the United States During the COVID-19 Pandemic

Cited by 6 publications

References 27 publications

Impact of State Telehealth Parity Laws for Private Payers on Hypertension Management before and during the COVID-19 Pandemic

Impact of State Telehealth Parity Laws for Private Payers on Hypertension Management before and during the COVID-19 Pandemic

Associations Between State Policies Facilitating Telehealth and Buprenorphine Episode Initiation and Duration Early in the COVID Pandemic

AI-Driven Analysis of Telehealth Effectiveness in Youth Mental Health Services: Insights from SAMHSA Data

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