Behavioral well being, main care and outpatient visits accounted for greater than 97% of telehealth claims acquired by BlueCross BlueShield of North Carolina (Blue Cross NC) during the last two years, in accordance with newly launched information. In response to the findings, the payer will replace its telehealth protection.
Starting January 1, Blue Cross NC will cowl telehealth companies for behavioral well being, main care and outpatient care. However it is not going to cowl telehealth companies that had been discovered much less efficient when supplied just about, akin to laboratory testing and radiology.
The brand new protection coverage can be relevant to all Blue Cross NC totally insured and administrative companies solely (ASO) plans. This contains the State Well being Plan. Nonetheless, it doesn’t cowl Blue Cross NC members who obtain telehealth companies from suppliers outdoors of North Carolina.
Jami Sowers, Blue Cross NC senior communications advisor, mentioned the modifications had been made to change into extra consultant of telehealth calls for.
“We goal to make sure our telehealth coverage displays findings from this era of elevated telehealth utilization by increasing choices so members can entry simple, inexpensive care irrespective of the place they stay,” Sowers wrote in an e mail to MedCity Information.
Further findings from the claims information embrace:
- In 2020, Blue Cross NC noticed a 7,500% enhance in telehealth claims. Complete member telehealth visits for behavioral well being and first care reached greater than 2.7 million in 2020, representing greater than 92% of all telehealth visits.
- For all in-person and digital claims in 2020, telehealth visits had been 47% of behavioral well being visits, 10% of household medication visits, 9% of main care visits, 7% of pediatric visits, 4% of OB/GYN visits and a couple of% of specialist visits.
- In 2021, 59 medical companies represented 99% of all paid telehealth claims.
Blue Cross NC’s information mirror total traits within the healthcare business. Telehealth use soared at first of the pandemic, however has since tapered off, in accordance with Kaiser Household Basis. Nonetheless, it’s nonetheless larger than it was pre-pandemic, and psychological well being utilization for telehealth has remained regular.
“The pandemic has radically modified how members want to entry care,” mentioned Dr. Stephen Friedhoff, senior vp of Well being Care Providers at Blue Cross NC, in a information launch. “The substantial enhance of telehealth utilization in the course of the pandemic has supplied two years of member information that’s extra informative than your entire 20 years prior when our firm first started overlaying telehealth. Blue Cross NC is responding to make sure our insurance policies mirror these findings by increasing telehealth choices so members can entry simple, inexpensive care irrespective of the place they stay.”
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