Telehealth Payment Parity and Outpatient Service Utilization: Evidence from Privately Insured Workers

Introduction 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. Method 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. Results 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. Conclusion Our findings underscore the important role of the 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

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UNC Libraries
Published
2025-05-02
DOI
https://doi.org/10.17615/n69k-ek03
Primary Topic
Telemedicine and Telehealth Implementation
Type
article
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0.00
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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.
UNC Libraries
Telemedicine and Telehealth Implementation
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

Abstract

Introduction 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. Method 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. Results 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. Conclusion Our findings underscore the important role of the 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.

UNC Libraries
University of North Carolina at Chapel Hill (US)
Openalex Percentile: Top 55%
Telemedicine and Telehealth Implementation
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Telehealth Payment Parity and Outpatient Service Utilization: Evidence from Privately Insured Workers — Christopher M. Shea, Zhang Zhang, et al. · UNC Libraries (2025) | TGRS Research Map | TGRS