Telemedicine has obvious cost and access advantages, but regulatory and other issues have stymied its rapid growth. A research letter in the Journal of the American Medical Association quantifies its growth in one large national health plan company with a substantial commercial and Medicare Advantage population. (JAMA Letter) Trends in telemedicine use were tracked from 2005 through 2017. The population used for the analysis is younger and somewhat more concentrated in the South than is the entire US population. Over the entire study period, there were about 384,000 telemedicine visits by 217,851 patients. But there were only 206 visits in 2005 and over 202,000 in 2017. The compounded annual growth rate in visits was 52% from 2005 through 2014 and 261% from 2015 to 2017, a period when more states began requiring equal coverage of telemedicine and many payers began to encourage use of telehealth. In the latter period the average age of users was around 38, 63% were female and 83% lived in urban areas. Over the complete study period, 53% of visits were for mental health issues, 39% were for primary care and the remainder were specialty visits. Both tele-mental health and primary care visits experienced rapid growth, particularly in recent years, and by 2017 primary care visits were the most common use of telemedicine. Tele-mental health visits increased faster in areas with no psychiatrists and in states with telehealth legislation. Primary care visits did not appear to be associated with physician supply in a geographic area or with telehealth parity laws. It is a positive development that telemedicine use appears to finally be growing more rapidly, as it generally delivers equivalent quality at lower prices and allows people with limited provider supply near where the live to access more clinicians.
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The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
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