Cambridge, MA, Dec. 16, 2021 — With telemedicine rising as an important alternative for access to care during the pandemic, a new Workers Compensation Research Institute (WCRI) FlashReport examines the utilization patterns of telemedicine services and the prices paid for these services in workers’ compensation systems across states during the early stage of the COVID-19 pandemic.
“Many anticipate that the higher utilization of telemedicine will persist, and, if so, the more prevalent use of telemedicine will change the landscape of medical care delivery permanently,” said John Ruser, president and CEO of WCRI. “There continues to be legislative and regulatory actions at the federal level and across states to address the process and reimbursement of telemedicine services. With the future of telemedicine yet to be observed, the utilization and prices of medical services delivered via telemedicine remain important measures to monitor in workers’ compensation.”
The FlashReport, Telemedicine: Patterns of Use and Reimbursement, focuses on two types of medical services with the most prevalent use of telemedicine: evaluation and management and physical medicine services. It investigates the patterns of telemedicine utilization among these services in workers’ compensation during the early months of the pandemic (primarily March–June 2020) across 28 states. It also examines the actual prices paid for the most frequent services delivered via telemedicine versus in person across the study states.
The following are among the major findings:
- Use of telemedicine in workers’ compensation displayed significant growth in the second quarter of 2020, with a wide variation in the use of telemedicine across states.
- In the vast majority of study states, prices paid for telemedicine services were similar to in-person services for evaluation and management and physical medicine—the two types of medical services with the most prevalent use of telemedicine.
- There was substantial interstate variation in the share of claims having their first office visit via telemedicine rather than in person, varying between 1 percent and 11 percent. In a typical state, about 4 percent of claims with evaluation and management had their first office visit as telemedicine.
- Six percent of workers with sprains and strains initiated their evaluation and management care via telemedicine, compared with 3 percent for workers with traumatic injuries.
- The setting of the initial evaluation and management service is an important factor explaining the use of telemedicine for follow-up services. If a patient had the initial office visit via telemedicine, about 65 percent of all follow-up visits for that patient were provided as telemedicine. In contrast, on average only 3 percent of all follow-up visits were provided via telemedicine for patients with initial in-person visits.
This report is based on a sample of workers’ compensation claims for private sector workers and local public employees (e.g., police and firefighters) from 28 states. The states are Arizona, Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Nevada, New Jersey, New Mexico, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin. These study states represent 77 percent of the workers’ compensation benefits paid nationwide.
Olesya Fomenko and Rebecca Yang are the authors of the report, which is free for members and available to nonmembers for a nominal fee. To download a copy of the report, visit www.wcrinet.org/reports/telemedicine-patterns-of-use-and-reimbursementa-wcri-flashreport.
The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Organized in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.