Mental Health Visits Take Majority of 1M Payer Telehealth Claims

Blue Cross Blue Shield of Massachusetts (“Blue Cross”) has seen a boom in telehealth visits, particularly to serve mental healthcare needs, the company announced.

The payer saw the number of telehealth claims rise from 200 per day in February 2020 to 38,000 per day in May 2020.

In nine weeks, the health plan has seen over 1 million telehealth visits.

"We're experiencing a revolution when it comes to telehealth use, both for medical and mental health care," said Andrew Dreyfus, president and chief executive officer of Blue Cross.

The claims data from Blue Cross is a testament to the rising importance of telehealth in the healthcare industry today, as many in-person visits have been replaced by virtual visits.

Two years ago, industry leaders knew that telehealth was starting to play a significant role in healthcare, but were still working out how to add these benefits into their health plans.

"It's likely that this kind of growth would otherwise have taken years, based on the trends we saw before the COVID-19 crisis,” Dreyfus added.

Now, telehealth is the front line of defense in primary care, behavioral healthcare, and, in particular, mental healthcare.

The claims data from Blue Cross underscore the overwhelming role telehealth plays in mental healthcare. Almost 50 percent of the health plan’s telehealth visits were mental health related.

“It's clear that the mental health impact of the pandemic will be felt for quite some time, even after we start the transition to a new normal,” noted Ken Duckworth, MD, senior medical director for behavioral health at Blue Cross. “Mental health support will continue to be critical as our response to the virus evolves.”

As the consumer base for telemental healthcare and other telehealth needs continued to grow, Blue Cross brought in an additional 400 mental healthcare workers over the course of a couple of months. The move increased its mental health provider network by over 30 percent to 15,000 clinicians.

“It's encouraging that so many of our members are seeking and getting the help they need during this incredibly challenging time,” said Duckworth.

While many payers are laying aside any previous challenges and covering telehealth services, the original barriers have not altogether disappeared.  Payers and providers alike still question: how will payers reimburse telehealth services?

Parity for non-telehealth mental and behavioral healthcare alone were in a dismal state when the nation plunged into the coronavirus early 2020. The disparity between primary care reimbursement and behavioral healthcare reimbursement rose by 3 percentage points between 2015 and 2017, according to a study by the Bowman Family Foundation.

For telehealth, payment parity likewise has been a source of conflict between payers and providers.

Some payers have not had to answer this question during the crisis because states have decided it for them. Specifically, in California, officials required that payer reimbursement for telehealth services match the rate of in-person care starting March 31. While the order was temporary, a permanent California rule goes into effect on January 1, 2021 that requires parity.

CMS also mandated payment parity for over 85 telehealth services offered by Medicare.

Some payers are choosing to cover these telehealth services at the same rate as in-person services. In its press release, Blue Cross stated that it will match in-person rates for all telehealth services as long as the public health emergency for Massachusetts is in place.

Other Blue Cross initiatives during the coronavirus pandemic included assigning over 100 employees to engage in the state’s contact tracing efforts. This represents one tenth of the workers Massachusetts expected to hire in order to track the spread of coronavirus in the state.