The Growth Channel

A surprising trend in telehealth: It's growing—but not where you might expect

by Tracy Walsh and Cara Goerlich

Most strategic planners and service line leaders know that telehealth activity has significantly expanded over the past 10 years, but do you know which services are driving that growth?

In our latest analysis of Medicare telehealth volumes, we found noteworthy differences in both growth rates and volumes among different telehealth services. To help you stay up-to-date in a rapidly deepening and diversifying telehealth market, we've identified three key growth trends to keep in mind.

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Medicare Fee-for-Service Trends in Telehealth Volumes

For a complete list of billing codes included in each category, please see the Telehealth Reimbursement Primer.

High volumes in specialty telehealth services


Specialty services, specifically those administered in rural hospitals, make up the majority of Medicare's telehealth volumes. This makes sense, given the wide range of applications that specialty services cover: inpatient and outpatient care, emergency department visits, and post-acute care consults. What's more, many organizations offer specialty services to address provider shortages, which are likely to continue.

Taking these factors together, we expect specialty services to maintain high volumes and grow steadily, especially with the addition of two new critical care telemedicine codes (G0508/9) in 2017.

Explosive growth in telebehavioral health services

Behavioral health volumes grew exponentially across the past six years, largely due to the scarcity of behavioral health workers and the ease with which telehealth can be applied to psychiatric services.

Although CMS did not establish new telebehavioral health codes in 2017, it has created several new codes since 2010. These additions include individual and group psychotherapy, screening, and pharmacologic management codes in 2014 and psychoanalysis, family psychotherapy, and prolonged evaluation codes in 2015. Moreover, legislation approved by Congress in 2016 to improve mental health parity and telementoring suggests that this striking growth in telebehavioral health services has not yet reached its ceiling.

Untapped potential in virtual chronic disease management

From 2010 to 2015, telehealth volumes for chronic disease management were consistently low. However, the addition of new care management codes in 2017 may spur future adoption.

Under its present fee-for-service model, Medicare does not reimburse providers for services administered via telemedicine in the patient's home. This restriction largely eliminates home-based chronic disease management consults and remote patient monitoring, telehealth modalities that are often used for patients with conditions like congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD). This year, CMS introduced a number of new telehealth codes, including services for patients with end-stage renal disease and advanced care planning. These new CPT codes and recent publications from government agencies signal that CMS is warming up to tele-chronic disease management.

Why telehealth technology isn't enough

There are dozens of telehealth technologies to choose from. But planners who ask, "What technology should I invest in?" are focusing on the wrong question.

Technology is a tool that enables strategy, not a stand-alone solution. To build a successful strategy that effectively leverages telehealth technology, download our infographic to learn three targeted questions you need to ask.

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