Zhang Zhang, Bundorf M Kate, Gong Qing, Shea Christopher M, Gilleskie Donna, Sylvia Sean Y
Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill 27599, United States.
Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill 27516, United States.
Health Aff Sch. 2025 Apr 1;3(4):qxaf068. doi: 10.1093/haschl/qxaf068. eCollection 2025 Apr.
Telehealth was catalyzed by the COVID-19 pandemic and has become a new norm in healthcare. In response to the pandemic, some states passed telehealth payment parity legislation, mandating equal payment rates for telehealth and in-person services. We evaluated the relationship between telehealth payment parity and health service utilization, focusing on insured workers in commercial insurance plans. Using the Merative Commercial Claims and Encounters database from 2019 to 2021, we leverage variation in the timing of policy changes across states using a difference-in-difference approach. Payment parity was significantly associated with increased telehealth visits and total outpatient visits but without a notable rise in in-person visits. Furthermore, payment parity was pronounced in increasing telehealth utilization within self-funded large employer plans, while not significantly associated with telehealth visits among fully insured small employer plans. Our findings underscore the important role of payment parity in increasing telehealth service utilization by incentivizing providers. Future policies should support the sustainable integration of telehealth services, shifting from solely focusing on equal payment rates to adopting value-based reimbursement models that improve equitable healthcare access for all employees in commercial insurance.
远程医疗因新冠疫情而得到催化,已成为医疗保健领域的一种新常态。为应对疫情,一些州通过了远程医疗支付平价立法,规定远程医疗服务和面对面服务的支付费率相等。我们评估了远程医疗支付平价与医疗服务利用之间的关系,重点关注商业保险计划中的参保员工。利用2019年至2021年的艾美仕商业理赔和诊疗数据库,我们采用双重差分法利用各州政策变化时间的差异。支付平价与远程医疗就诊次数和门诊总就诊次数的增加显著相关,但面对面就诊次数没有明显增加。此外,支付平价在增加自筹资金的大型雇主计划中的远程医疗利用率方面表现明显,而与全额保险的小型雇主计划中的远程医疗就诊次数没有显著关联。我们的研究结果强调了支付平价在通过激励提供者来提高远程医疗服务利用率方面的重要作用。未来的政策应支持远程医疗服务的可持续整合,从单纯关注支付费率平等转向采用基于价值的报销模式,以改善商业保险中所有员工的公平医疗服务可及性。