CO Telehealth Utilization Skyrocketed Following PHE Onset

July 17, 2023 - Data from the Center for Improving Value in Health Care (CIVHC) indicated that Colorado, like many other states, had higher telehealth utilization and increased spending following the onset of the COVID-19 pandemic, spending hundreds of dollars annually per person for telehealth services.

Collected by the CIVHC, this data comes from a telehealth service analysis that includes data from Colorado residents. Although most residents are considered, the analysis omits the self-insured and those under federal health insurance.

For telehealth utilization, March 2020 was a turning point. CIVHC data indicated that between March 2020 and January 2022, 9.23 million total telehealth services took place in Colorado, totaling $1.04 billion in total spending. During this time, 1,480 telehealth services were provided per 1,000 people, and $290 was spent annually per patient.

Comparatively, between January 2019 and February 2020, Colorado provided 231,236 total services, costing $19.82 million. The state provided 62 telehealth services per 1,000 people during this time, totaling $9 in annual spending per patient.

Both before and after the onset of the pandemic, mental health conditions were the most common reason for telehealth use. Prior to the start of the public health emergency (PHE), 32 percent of telehealth diagnoses involved mental health conditions, followed by respiratory system diseases (13 percent). After the start of the PHE, 53 percent of telehealth diagnoses involved mental health, which was by far the top diagnosis category.

Regarding providers that engaged in telehealth most often, primary care (41 percent) and behavioral health (29 percent) providers most commonly used the care modality prior to the PHE. After the onset of the pandemic, behavioral health providers were the top providers of telehealth at 39 percent, followed by primary care providers at 22 percent.

Younger populations — those aged 18 to 44 — were, by far, the most significant telehealth users. Pre-pandemic, 34 percent of encounters involved this population, followed by those 65 and over, participating in 31 percent of telehealth visits. After the onset of the PHE, 36 percent of encounters involved those aged 18 to 44, followed by those younger than 1 to 17, who engaged in 23 percent of visits.

Similar to prior research, White people used telehealth more than other racial groups after the pandemic began. Female patients (61 percent) also used telehealth more than male patients (39 percent) after March 2020.

Overall, trends indicate that telehealth use remains high compared to pre-pandemic levels.

March 2020 marked the start of the PHE, resulting in an intense skyrocketing in telehealth use. Although this high usage rate did sustain for many months, telehealth use has since dropped in certain healthcare areas.

In April, FAIR Health provided data that showed how telehealth use fell in 2021 and 2022, following a rise in 2020.

FAIR Health data showed that between 2019 and 2020, telehealth use across various primary care specialties increased. Physician assistants, nurse practitioners, and pediatricians experienced the largest increase.

Between 2020 and 2021, however, there was a 36 percent drop in the percentage of patients seen through telehealth among physician assistants, nurse practitioners, and internal medicine physicians.