Differences in Telehealth During COVID-19 Between Commercial and Medicaid Enrollees

ABSTRACT

Objectives: To compare how in-person evaluation and management (E&M) visits and telehealth use differed during the COVID-19 pandemic between commercially insured and Medicaid enrollees, and to assess how insurance plan type—fee-for-service (FFS) vs managed care (MC)—and enrollee characteristics contributed to these differences. Study Design: Retrospective cohort analysis of 2019 and 2020 data from the commercially insured California Public Employees' Retirement System (CalPERS) and the California Medicaid program (Medi-Cal). Am J Manag Care. 2023;29(1)In Press _____ Takeaway Points * Increased use of telehealth during the COVID-19 pandemic has raised concerns about equitable access among lower-resourced populations, but few direct comparisons of telehealth use exist. * Compared with enrollees in a large, commercially insured managed care plan, Medicaid managed care enrollees had lower use of telehealth. * However, compared with enrollees in a large, commercially insured fee-for-service plan, Medicaid fee-for-service enrollees had higher use of telehealth. * Both insurer and plan type interact to affect uptake of telehealth, indicating heterogeneity that policy makers may wish to address when writing future telehealth policies. _____ The COVID-19 pandemic prompted a large shift to the provision of telehealth, due to benefits that include reduced risks of COVID-19 transmission and more convenient access to care. CalPERS enrollees select their insurance plan from several options, including a fully integrated health plan offered by Kaiser Permanente, several non-Kaiser health maintenance organization (HMO) plans, and preferred provider organization (PPO) plans.