Telehealth payment parity and outpatient service utilization: evidence from privately insured workers

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.

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Publication Details

Journal
Health Affairs Scholar
Published
2025-03-29
DOI
https://doi.org/10.1093/haschl/qxaf068
Citations
4
Primary Topic
Healthcare Systems and Reforms
Type
article
Field-Weighted Citation Impact
8.83
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article

Telehealth payment parity and outpatient service utilization: evidence from privately insured workers

Christopher M. Shea, Zhang Zhang, M. Kate Bundorf, Donna Gilleskie et al.
4 citations
Health Affairs Scholar
Healthcare Systems and Reforms
8.83
article

Telehealth payment parity and outpatient service utilization: evidence from privately insured workers

Christopher M. Shea, Zhang Zhang, M. Kate Bundorf, Donna Gilleskie, Sean Sylvia, Qing Gong
article en
4 citations

Abstract

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.

Health Affairs ScholarVol. 3(4)
University of North Carolina at Chapel Hill (US), Public Policy Institute of California (US), Johns Hopkins University (US), Duke University (US)
Openalex Percentile: Top 3%
Healthcare Systems and Reforms
8.83
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Telehealth payment parity and outpatient service utilization: evidence from privately insured workers — Christopher M. Shea, Zhang Zhang, et al. · Health Affairs Scholar (2025) | TGRS Research Map | TGRS