Telehealth payment parity and outpatient service utilization: evidence from privately insured workers.

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2025-04

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Abstract

Telehealth was catalyzed by the COVID-19 pandemic and has become a new norm in healthcare. In response to the pandemic, some states passed telehealth payment parity legislation, mandating equal payment rates for telehealth and in-person services. We evaluated the relationship between telehealth payment parity and health service utilization, focusing on insured workers in commercial insurance plans. Using the Merative Commercial Claims and Encounters database from 2019 to 2021, we leverage variation in the timing of policy changes across states using a difference-in-difference approach. Payment parity was significantly associated with increased telehealth visits and total outpatient visits but without a notable rise in in-person visits. Furthermore, payment parity was pronounced in increasing telehealth utilization within self-funded large employer plans, while not significantly associated with telehealth visits among fully insured small employer plans. Our findings underscore the important role of payment parity in increasing telehealth service utilization by incentivizing providers. Future policies should support the sustainable integration of telehealth services, shifting from solely focusing on equal payment rates to adopting value-based reimbursement models that improve equitable healthcare access for all employees in commercial insurance.

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commercial insurance, outpatient service, telehealth payment parity, worker

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Published Version (Please cite this version)

10.1093/haschl/qxaf068

Publication Info

Zhang, Zhang, M Kate Bundorf, Qing Gong, Christopher M Shea, Donna Gilleskie and Sean Y Sylvia (2025). Telehealth payment parity and outpatient service utilization: evidence from privately insured workers. Health affairs scholar, 3(4). p. qxaf068. 10.1093/haschl/qxaf068 Retrieved from https://hdl.handle.net/10161/32349.

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Bundorf

M. Kate Bundorf

J. Alexander McMahon Distinguished Professor of Health Policy and Management

Professor Bundorf’s research focuses on health policy and the economics of health care systems. She has studied public and private health insurance markets, the organization of health care providers, and consumer decision making in health care. Prior to joining the faculty at Duke, Professor Bundorf was an associate professor of health research and policy at the Stanford University School of Medicine. She is also a faculty research fellow at the National Bureau of Economic Research. Bundorf received her MBA and MPH from The University of California at Berkeley and her PhD from The Wharton School. She was a Fulbright Lecturer at Fudan School of Public Health in Shanghai, China during 2009 and 2010. Her research has been published in leading economic and health policy journals and has received funding from the U.S. National Institutes of Health, the Agency for Health Care Research and Quality, and the Robert Wood Johnson Foundation. She received the 13th Annual Health Care Research Award from The National Institute for Health Care Management in 2007.


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