The Role of Telehealth Payment Parity on Recommended Care and Emergency Department Service Utilization Among Workers With Chronic Conditions

Bibliographic Data

ID9101135
AuthorsZhang Zhang (0000-0001-9344-6578, Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, corresponding author), M Kate Bundorf (0000-0002-9824-4868, Duke University), Qing Gong (0000-0001-5032-8539, Department of Economics, The University of North Carolina at Chapel Hill, Chapel Hill, NC), Justin G Trogdon (0000-0001-5484-7870, Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, corresponding author), Donna Gilleskie (0000-0002-1278-7707, Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC), Sean Sylvia (0000-0002-9508-247X, University of North Carolina at Chapel Hill, corresponding author), Sean Y Sylvia (Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC)
Year2025
Volume63
Issue10
Pages779-786
Publication date2025-10-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000002185
PMID40730341
OpenAlexW4412769611
LanguageEN
References cited25

BACKGROUND AND OBJECTIVE: State-level telehealth payment parity, requiring equal payment rates for telehealth and in-person visits, played an important role in ensuring access to telehealth services. The objective of our study is to evaluate how improved access, driven by telehealth payment parity, affected the utilization of disease-specific recommended care management services and emergency department (ED) services among insured patients with chronic conditions. RESEARCH DESIGN: We adopted a 2-way fixed-effect difference-in-differences approach using the Merative Commercial Claims and Encounters database from 2019 to 2021. SUBJECTS: We focused on insured workers aged 19-64 with pre-existing mental health disorders or cardiometabolic risks (CMRs). MEASURES: Outcomes include psychotherapy for mental health disorders, preventive care counseling for CMRs, and ED visits. RESULTS: Telehealth payment parity was associated with a significant increase in the number of psychotherapy visits and tele-psychotherapy by 0.221 visits (95% CI: 0.050-0.391) and 0.411 visits (95% CI: 0.003-0.818) per patient per quarter, respectively. The regulation significantly reduced E.D. visits among individuals with mental health disorders by 0.003 visits (95% CI: -0.007 to 0.000) per quarter, a 25% relative decrease compared with the control at preperiod. However, payment parity was not statistically associated with increasing preventive care visits and lowering ED visits among individuals with CMRs. CONCLUSION: Telehealth payment parity has effectively promoted the adoption of psychotherapy and reduced ED visits among insured workers with mental health disorders. However, it has not significantly improved the uptake of preventive care counseling for individuals with CMRs

Business · Emergency department · Family medicine · Health care · Medical emergency · Mental health · Payment · Psychiatry · Quarter (Canadian coin) · Telehealth · Telemedicine · Digital Mental Health Interventions · Finance · Medicine · Mental Health Treatment and Access · Nursing · Telemedicine and Telehealth Implementation

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