Dive Brief:
- The median charge for a hospital evaluation and management visit increased 7% from 2019 to 2020 while negotiated rates for those visits rose 5%, continuing a steady upward trend since 2012, according to a new report from Fair Health.
- Meanwhile, the percentage of claims for telehealth shot up from just 0.22% of all claims in 2019 to about 15% in 2020, as COVID-19 restrictions set in and patients worried of virus transmission, Fair said.
- Volumes in all other areas fell, with ambulatory surgery centers seeing the biggest decrease at 38%.Visits dropped 30% for emergency rooms, 16% for urgent care centers and 4% for retail clinics.
Dive Insight:
Fair Health's report illustrates the enormous impact the COVID-19 pandemic has had on how Americans use healthcare, particularly in the shift to virtual visits. Previous reporting from the nonprofit showed telehealth use rising and falling alongside coronavirus waves, but investors are betting patients will continue turning to them post-pandemic.
Telehealth use increased more in urban areas than rural ones from 2019 to 2020. The most common diagnosis was mental health conditions, making up 44% of all claims. That comes as investment in the area is also going up, reaching a record high of $5.5 billion in equity funding for mental health tech startups in 2021, according to CB Insights.
The need for COVID-19 testing and treatment drove exposure to communicable disease to become one of the most common reasons for a virtual visit or a trip to a retail clinic or urgent care in 2020.
The information in the Fair Health report is drawn from a database of 36 billion claims provided by payers and private plan administrators.
It showed that retail clinic visits dropped slightly from 2019 to 2020, particularly in rural areas, but has grown since 2017. Retail giants like CVS Health and Walgreens have recently been investing more in the area, dedicating additional space to health products and adding more providers to their staff.
The most common retail clinic claim in 2020 continued to be acute respiratory diseases and infections, making up a quarter of all claims. That diagnosis also topped the list for urgent care centers.
Offices generally charged the most for E/M visits, followed by urgent cares and then retail clinics. Charges for those encounters in a non-hospital professional setting rose 4% from 2020 to 2021.
While ER visits dropped 30% from 2019 to 2020, they have grown 15% since 2011.