JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic triggered policy changes in 2020 that allowed insurance companies to reimburse telehealth services, which led to increased telehealth usage, especially in rural and medically underserved areas. However, with many emergency rules ending in 2022, patients and providers are concerned about a potential loss of access to these services.

Objective:

To inform reimbursement decisions, our analysis examines telehealth usage in Arkansas from 2017 to 2022, drawing on electronic medical records collected by the University of Arkansas for Medical Sciences Medical Center (UAMSHealth).

Methods:

We employed statistical tools to compare the number of telehealth and in-person visits for specific specialties, including OB/GYN, Psychiatry, Family Medicine, Gerontology, Internal Medicine, Neurology, and Neurosurgery, and investigated insurance coverage trends for each. Our evaluation also included a procedure to calculate appointment performance metrics such as waiting time and appointment length.

Results:

Limiting telehealth access by returning to pre-pandemic regulations could negatively impact Arkansas, where a large population resides in medically underserved and rural areas. However, our analysis indicates that telehealth usage in Arkansas remained stable beyond 2020, with the number of psychiatry telehealth visits continuing to increase in 2021 and 2022. We hope our findings will influence insurance companies and policymakers to consider reimbursement policies not only in Arkansas but also in other regions facing similar healthcare access challenges.

Conclusions:

Our analysis revealed a significant increase in telehealth visits across all specialties, showing an 89% increase from 2019 to 2020 and a subsequent 21% increase from 2020 to 2021. Meanwhile, the total number of in-person visits covered by Medicare and Medicaid decreased by 15% in 2022 compared to 2019. Psychiatry, OB/GYN, and Family Medicine had the highest number of telehealth visits. The waiting time for Psychiatry telehealth visits was almost 50% shorter than in-person visits. These findings highlight the potential benefits of telehealth in providing access to healthcare, particularly for patients needing psychiatric care.