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FAIR Health is a national, independent nonprofit organization dedicated to bringing transparency to healthcare costs and health insurance information through data products, consumer resources and health systems research support. FAIR Health possesses the nation’s largest collection of private healthcare claims data, which includes over 36 billion claim records and is growing at a rate of over 2 billion claim records a year.

The new FAIR Health white paper containing the fifth annual edition of FH® Healthcare Indicators and FH® Medical Price Index, shows that telehealth utilization grew nationally 7,060 percent from 2019 to 2020, an increase driven by the COVID-19 pandemic and the limits imposed on certain in-office services, coupled with the greater risk of infection from in-person encounters.

FH Healthcare Indicators reveal trends and patterns in the places where patients receive healthcare. Focusing on alternative places of service – retail clinics, urgent care centers, telehealth and ambulatory surgery centers (ASCs) – as well as emergency rooms (ERs), FH Healthcare Indicators evaluate changes in utilization, geographic and demographic factors, diagnoses, procedures and costs.

Among the key findings:

– – Due to the pandemic and the limits imposed on certain in-office services, coupled with the increased risk of infection from in-person encounters, telehealth grew in 2020 on a scale unseen in previous years. Telehealth utilization increased nationally 41,919 percent from 2015 to 2020, a more than 40-fold increase over the growth of 1,019 percent from 2014 to 2019 reported in last year’s edition. From 2019 to 2020, national growth was 7,060 percent.
– – In all other places of service studied for changes in utilization, utilization decreased from 2019 to 2020, probably because of the impact of COVID-19. Utilization fell 38 percent in ASCs, 30 percent in ERs, 16 percent in urgent care centers and 4 percent in retail clinics.
– – Among the places of service studied, telehealth held the highest percentage of medical claim lines in 2020, with 15.41 percent of all medical claim lines nationally. The comparable percentages for the other places of service were 2.07 percent for ERs, 1.31 percent for urgent care centers, 0.64 percent for ASCs and 0.05 percent for retail clinics.
– – In 2020 as in previous years, more claim lines were submitted for females than males in most age groups in the places of service in which FAIR Health studied gender-related patterns—retail clinics, urgent care centers, telehealth, ASCs and ERs.
– – However, in some places of service, such as retail clinics, urgent care centers, ASCs and ERs, the gap between males and females narrowed. For example, in ERs, in the age group 61-70, the male and female shares were approximately equal (50 percent) in 2020, a change from 2019, when the female share had been 52 percent and the male share 48 percent. This trend bears monitoring in the future.
– – In 2020, the five states in which retail clinic claim lines constituted the greatest percentage of medical claim lines were (from greatest to least) Arkansas, Missouri, Rhode Island, Maine and Minnesota. In 2018, Minnesota had ranked first in this list; in 2019, it ranked third, and in 2020 it fell to fifth.
– – Connecticut, which had been fourth from the bottom in its use of telehealth as a percentage of all medical claim lines by state in 2019, rose to fifth from the top in 2020.
– – In 2020, exposure to communicable diseases joined the list of most common diagnostic categories in retail clinics, urgent care centers and telehealth. This category largely was associated with testing and/or treatment for COVID-19 when a patient was exposed to the condition.
– – Across offices, urgent care centers and retail clinics in 2019, urgent care centers had the highest median charge amount for CPT®2 99203 (30-44-minute new patient office visit), but in 2020 the median charge for an office ($226) was slightly higher than that for an urgent care center ($221).

FH Medical Price Index reports shifts in costs and facilitates useful comparisons among medical prices in six procedure categories from May 2012 to November 2021:

– – Of the six procedure categories, hospital E&Ms had the greatest percent increase in charge amount index, seven percent, and in allowed amount index, five percent.
– – Radiology and medicine each had the smallest percent increase in charge amount index, two percent.
– – Radiology had the smallest percent increase in allowed amount index, one percent.

FAIR Health President Robin Gelburd stated: “This year’s edition of FH Healthcare Indicators and FH Medical Price Index opens a window on the impact of the COVID-19 pandemic on the nation’s healthcare system. We hope that this new edition, like those in previous years, continues to inform decision making throughout the healthcare sector by payors, providers, government officials, policy makers, academic researchers and others.”