Americans are slowly returning to medical facilities to receive care and are using fewer telehealth services after last year's pandemic high, according to new data.
Telehealth utilization fell nationally for the third straight month, according to FAIR Health's Monthly Telehealth Regional Tracker.
Telehealth claim lines dropped 12.5% nationally as a percentage of medical claim lines, decreasing from 5.6% of claim lines in March 2021 to 4.9% in April, the data shows.
This was a greater decrease than the drop of 5.1% in March but not as steep as the decrease of almost 16% in February. Telehealth usage also declined in April in all four U.S. census regions, with the greatest decline in the South, where the decrease was 12.2%. The data represent the privately insured population, excluding Medicare and Medicaid.
The decline in telehealth utilization appears largely to be driven by the shift back to in-person visits at hospitals and other healthcare settings.
While telehealth use overall contracted, virtual visits for mental health conditions, the number one telehealth diagnosis, continued to rise nationally and in every region. Mental health claims rose from 57% of overall telehealth claim lines in March 2021 to 58.6% in April.
Likewise in April, psychotherapeutic/psychiatric codes increased nationally as a percentage of telehealth procedure codes, whereas evaluation and management (E&M) codes decreased.
In April, acute respiratory diseases and infections increased as a percentage of telehealth claim lines nationally and in the Midwest and South.
Fair Health's Monthly Telehealth Regional Tracker launched in May 2020 to track how telehealth is evolving from month to month.
As the COVID-19 pandemic wanes, this suggests a return to non-COVID respiratory conditions, such as colds and bronchitis. Also in April, general signs and symptoms joined the top five telehealth diagnoses in the West, again suggesting a return to more "ordinary," non-COVID conditions such as colds and stomach viruses.
Fair Health's analysis mirrors similar data from health system analytics company Trilliant Health which showed that telehealth is declining as much as 37% from peak-pandemic highs in some states.
In California, telehealth utilization is down 24% and virtual care visits are down 30% in Louisiana, Trilliant Health's data shows.
Despite the decline in telehealth use, virtual care companies continue to make big investments in digital capabilities. In the first quarter of 2021, telehealth investment hit an all-time high of $4.2 billion in just 139 deals, almost doubling the $2.2 billion raised in the same quarter in 2020, according to CB Insights.
Telehealth use spiked during the pandemic after the Centers for Medicare & Medicaid Services gave more flexibility for providers to get reimbursed by Medicare for such services. These changes, along with expanded coverage from commercial insurers, helped to open up access to healthcare services, telehealth advocates say.
Many provider groups are clamoring for Congress and federal regulators to permanently expand coverage for telehealth visits once the COVID-19 public health emergency ends. And President Joe Biden's top health official signaled that the administration supports broadening the use of virtual care in the long term.
But without financial incentives, providers will likely be less inclined to use telehealth. Some big insurers are pulling back some of their telehealth coverage for non-COVID-19-related issues, the Wall Street Journal reported last fall.
UnitedHealthcare, for example, rolled back policies last fall that waived copays and other fees for non-coronavirus appointments. Anthem BlueCross BlueShield extended coverage through the end of 2020, but only the first two sessions are free for the consumer.