Telehealth Adoption Tracker

From The Chartis Group and Kythera Labs

The Chartis Group
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Chicago, IL 60654

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The Chartis Group and Kythera Labs have brought together a team of data scientists, visualization experts and industry thought leaders to develop the Telehealth Adoption Tracker, an advanced analytic tool designed to measure how COVID-19 has driven rapid telehealth adoption across the country. The Telehealth Adoption Tracker allows a user to analyze how geographies and specialties have been impacted by the rapid switch to telehealth over time.

This interactive tool allows users to filter by geographic and market level dimensions – exploratory functionality is available throughout the dashboard to isolate to segments of interest. Data will be refreshed on a routine basis as we continue to monitor and track telehealth adoption and its impact on the healthcare ecosystem.

Analytics Methodology

Underlying data provided by Kythera Labs are sourced from clearinghouse claims vendors which comprise a national representation of submitted professional medical claims. These claims include self-insured and fully insured health plans across most major commercial payors and Medicare Advantage. The level of claims coverage varies by geography. Geographic and specialty utilization patterns may change over time based upon timing and mix of claims reporting by clearinghouse. Data is refreshed on a weekly basis, which includes data for the subsequent week, in addition to newly submitted claims from prior weeks.

Effective July 2020: Modified methodology has been implemented for geographic analysis, now defined based upon patient location.

Data excludes providers billing from US territories: Puerto Rico, Guam and the Virgin Islands. Telehealth adoption rates for multi-state CBSAs will aggregate into the respective telehealth adoption rate calculation, identified and assigned by the respective provider state. Physician specialties are determined based upon the specialty assigned to the rendering provider NPI. Certain physician specialties are combined or excluded to form the 20 specialties reported in the analysis. APP-defined practitioners have been excluded from this analysis. Percentage telehealth rate is calculated as the ratio of unique telehealth visits as a proportion of total physician visits.

Return to the Chartis COVID-19 Resource Center

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Prior to the COVID-19 outbreak, telehealth visits represented less than 1 percent of all physician visit volumes. By the fourth week of April 2020, 42 percent of all physician visits nationwide were being performed via telehealth. COVID-19 has ushered in a new era for telehealth, accomplishing in weeks what many thought would take years. Not unexpectedly, telehealth adoption is not uniform across regions, specialties or consumer segments. Analyzing trends over the last six weeks raises three important considerations for providers regarding the long-term role telehealth will play in the care delivery ecosystem, which are shared in this report:

DOWNLOAD REPORT FROM MAY 2020

Telehealth: Current Trends and Long-Term Implications
A joint thought leadership perspective by The Chartis Group and Kythera Labs
Published May 22, 2020

Telehealth growth will stabilize as physician offices reopen, but remain an essential component of care delivery.

Telehealth will impact every physician specialty—from primary care to medical and surgical disciplines. 

Telehealth’s impact on health disparities must be understood and addressed.

As the telehealth landscape continues to evolve, we will continue to monitor the trends to answer key questions, including: When will telehealth visits level out and form a new status quo? Which specialties will continue to see higher levels of telehealth adoption in the long term? How is telehealth addressing or exacerbating health disparities between geographic, socioeconomic, racial/ethnic and other population segments? 

Telehealth for Pediatric Populations
Telehealth utilization varies for like-specialties in pediatric vs. adult populations. For example, during the week of April 11th, neurology specialists saw pediatric telehealth utilization spike to 79 percent vs. only 63 percent in the adult population. Notably, pediatric neurology telehealth utilization only declined to 69 percent, as compared to 46 percent for adults in the most recent week of data. Similar patterns are occurring across several other pediatric medical specialties, including gastroenterology and pulmonology.

Behavioral Health as a Telehealth Champion
Behavioral health has shown more resilience in sustaining telehealth utilization than have other specialties. As physician visit volumes for behavioral health/psychiatry begin to return, telehealth adoption is continuing to build momentum, reaching 64 percent as of mid-May. This suggests this specialty may have turned a corner in how to effectively embed telehealth within care models.

Telehealth Adoption Varies by Market
As noted in our original article, we’ve seen telehealth adoption trends vary by market based upon COVID-19 incidence and state and local guidelines for stay-at-home orders. Markets that reopened more quickly such as Dallas and Jacksonville  saw adoption decline to 25 percent and 17 percent, respectively, whereas markets with a higher incidence of COVID-19 remained above the national average of telehealth adoption through mid-May,such as Detroit (42 percent) and New York City–Newark (45 percent).

Decreasing Utilization of Telehealth
Not unexpectedly, while total physician visit volumes are beginning to recover as practices reactivate, the relative proportion of telehealth visits is beginning to decline. By the week of May 18th, telehealth adoption declined to 29 percent (from a peak of 47 percent) of total physician visit volumes. This proportional shift is a result of both a significant increase in in-person care as well as decreased telehealth utilization in certain specialties.

Chartis and Kythera Labs are continuing to follow trends in telehealth adoption across the country. With the most recent data available through May 18, after an initially rapid expansion of telehealth in the first phase of COVID, we are starting to see some decline in telehealth adoption as shelter-in-place orders are starting to lift and phased reopening plans are initiated.  A few highlights regarding what this latest data shows include:

Previous Telehealth Adoption Trends
Published June 18, 2020 

The Latest in Telehealth Adoption Trends
Published August 6, 2020 

National telehealth utilization has stabilized.
Telehealth made up 18 percent of all physician visits during the week beginning July 20. This is the sixth straight week that telehealth utilization has remained between 18 and 20 percent of all visits — well down from a peak of 50 percent in mid-April — indicating that this range may represent a “new normal” during the COVID-19 period and under the current telehealth regulatory and reimbursement rules.

If you would like to learn more about work by The Chartis Group and Kythera Labs regarding telehealth and demand recovery across the healthcare ecosystem, please contact us.

Meanwhile, telehealth adoption rates within COVID-19 “hot-spot” states rose.
Countering the national trend, telehealth rates increased in many states that experienced the biggest spikes in COVID-19 cases from mid-June through mid-July. Florida (21 percent telehealth adoption rate), Texas (23 percent) and Arizona (21 percent) saw telehealth utilization rates increase by 4 to 6 points since mid-June and each state now sits above the national telehealth average.

The urban and rural telehealth divide is pronounced and shows signs of widening. 
Rates of telehealth use in urban areas have exceeded those in rural geographies since the beginning of the pandemic. The telehealth adoption rate for primary care visits was 28% higher in urban geographies than rural ones in the most recent week of data. While overall telehealth adoption has stabilized recently, the urban-rural telehealth divide has widened since the early weeks of the pandemic—up from an 18% differential during the peak telehealth adoption weeks in mid-April.

Telehealth has predominantly functioned as a modality to manage established patients.
New patients represent just 5 percent of overall telehealth visits, compared to 13 percent of in-person visits throughout the COVID period indicating that virtual care modalities to date have been primarily utilized as tools to manage care for established patients. Finding ways to leverage telehealth to expand access to new patients will be a key driver of telehealth’s continued adoption and growth. 

Chartis and Kythera Labs are continuing to monitor telehealth adoption and utilization across the US and post our weekly Telehealth Adoption Tracker to enable drill-down analysis of specific markets. We recently refreshed our data through the week of July 20th and examined the emerging and abating trends. Here are a few highlights reflecting the latest data-driven findings.

View Previous Insights

Click below to view previous telehealth adoption insights 
and accompanying thought leadership.