Anthem Sees Different Telehealth Adoption Rates Among Populations

Different populations adopt telehealth at different rates and for different reasons, so a strategy that seeks to address social determinants of health with a one-size-fits-all approach won’t work.

That’s the takeaway from a recent review of Medicaid claims data by Anthem, which surveyed telemental health use in 14 states during the height of the coronavirus pandemic. And while it found that telehealth visits for mental health services surged overall from less than 10 percent to almost 50 percent during that time span, some groups were better at using it than others.

"While telehealth wasn’t a panacea in eliminating health equity gaps, it helped boost connectivity for all and made Internet visits possible when COVID temporarily closed physical doors, allowing health care to continue to be delivered with some semblance of normalcy,” Shantanu Agrawal, MD, the Indiana-based payer’s chief health officer, said in a press release.

Among specific populations, Hispanic and Latino communities embraced telehealth for mental health services during COVID-19 at the highest rate, at 40 percent, while 34 percent of white members, 33 percent of Asian members and 28 percent of black members were accessing online care.

Those rankings weren’t all that different from the percentages of each group accessing virtual care and in-person visits for mental health services prior to the pandemic, but they do show a significant drop in any kind of visits overall – almost 8 percent - as a result of COVID-19.

For example, among blacks, whom researchers say have experienced much higher levels of behavioral health challenges during the pandemic, overall visits dropped from 56 percent pre-pandemic to 49 percent during the pandemic. And when compared to white members with similar socioeconomic, demographic and clinical backgrounds, black members reported 7.4 percent fewer visits.

Meanwhile, Hispanic and Latino members embraced telehealth faster than white members, by an 8.1 percent margin. And while they were more likely to visit an Emergency Department for mental health services pre-pandemic, they saw the largest reduction in such visits during the pandemic.

"There are likely many reasons behind the differences in mental health care visits, including issues that prevent people from seeking care, such as medical injustices and a history of receiving culturally insensitive care,” Agrawal said in the press release.

“Health equity is a key driver for mental and physical well-being,” he added. “To achieve equity in our healthcare, we need to understand where and why barriers to health exist, and then couple these insights with the scale and scope of Anthem to drive changes to a new system of health, that puts equity at the center.”

A lot of that growth in connected health access came as a result of emergency actions by federal and state governments to expand the reach of and coverage for telehealth and mHealth services. With that in mind, telehealth advocates and lawmakers are putting pressure on both the Centers for Medicare & Medicaid Services and Congress to permanently extend those measures.

Beyond that, many organizations are developing strategies to identify SDOH and better understand how telehealth can be used to attack those barriers and reduce gaps in care. And, as the Anthem data points out, they’re finding that the barriers are different with each population.