Wang James, Patel Vikeen, Salek Sara, Abbaszadegan Hamed, Rehman Shakaib, Garcia-Filion Pamela
Department of Biomedical Informatics, College of Medicine-Phoenix, University of Arizona, Phoenix, Arizona, USA.
Arizona Health Care Cost Containment System, Phoenix, Arizona, USA.
Telemed J E Health. 2023 Mar;29(3):408-413. doi: 10.1089/tmj.2021.0580. Epub 2022 Jul 11.
The recent pandemic caused by the 2019 novel coronavirus (COVID-19) resulted in declaration of a national emergency (NE) in March 2020. The Centers for Medicare and Medicaid Services quickly responded with temporary expansion of telehealth coverage policies. To determine the impact of implementing a temporary telephonic code set in a state Medicaid population by comparing the utilization patterns of telehealth claims before and after a NE announcement. This was a retrospective cohort study conducted with the Arizona Medicaid program, the Arizona Health Care Cost Containment System (AHCCCS). Data include telehealth claims submitted to AHCCCS between January and May 2020 by contracted managed care organizations. Approximately 2.3 million telehealth claims were analyzed in this study. Utilization of the audio-visual (A/V) modality increased 1,610% and telephonic visits increased 408% compared with pre-NE. Compared with pre-NE, three provider type groups increased their utilization of telephonic visits from 1.8% to 50.8% as a result of the temporary telephonic set post-NE. Rural counties had higher rates of telephonic modality adoption, whereas urban counties adopted the A/V modality more readily. Ten telephonic codes constituted 87% of all telehealth claims, with the majority of those codes used for behavioral health and established office visit types. The telephonic modality was adopted more frequently in rural areas and the A/V modality in urban areas. There were several new provider types utilizing telehealth as a result of the temporary telephonic code set implementation.
2019年新型冠状病毒（COVID-19）引发的近期大流行导致2020年3月宣布全国紧急状态（NE）。医疗保险和医疗补助服务中心迅速做出回应，临时扩大了远程医疗覆盖政策。通过比较全国紧急状态宣布前后远程医疗索赔的使用模式，以确定在一个州的医疗补助人群中实施临时电话代码集的影响。这是一项对亚利桑那州医疗补助计划——亚利桑那医疗成本控制系统（AHCCCS）进行的回顾性队列研究。数据包括2020年1月至5月期间签约管理式医疗组织提交给AHCCCS的远程医疗索赔。本研究分析了约230万份远程医疗索赔。与全国紧急状态宣布前相比，视听（A/V）模式的使用增加了1610%，电话问诊增加了408%。与全国紧急状态宣布前相比，由于全国紧急状态宣布后的临时电话代码集，三个提供者类型组的电话问诊使用率从1.8%提高到了50.8%。农村县采用电话模式的比例更高，而城市县更容易采用视听模式。十个电话代码占所有远程医疗索赔的87%，其中大多数代码用于行为健康和既定的门诊类型。电话模式在农村地区的采用更为频繁，视听模式在城市地区更为常见。由于临时电话代码集的实施，出现了几种新的利用远程医疗的提供者类型。
