Medicare FFS Telehealth Visits Eclipsed 52.7 Million in 2020

December 07, 2021 - What is the future of telehealth for Medicare beneficiaries? Data shows utilization skyrocketed between 2019 and 2020.

Medicare Telehealth Use Reached New Heights in 2020

In one year, telehealth usage by Medicare fee-for-service beneficiaries increased 63-fold — from approximately 840,000 virtual visits in 2019 to nearly 52.7 million in 2020, according to a new federal report.

Prepared by the Department of Health and Human Services' Office of the Assistant Secretary for Planning and Evaluation, the report analyzed the use of in-person and telehealth visits by Medicare FFS beneficiaries from January to December 2020 and compared it with data from the same period in 2019.

With the expanded Medicare telehealth flexibilities enacted in 2020, telehealth use by Medicare patients increased to 16.6 million for specialist appointments, a 38-fold increase from 122,400 the previous year. Similarly, telehealth use skyrocketed to 10.1 million for behavioral health specialist appointments, a 32-fold jump from 317,800 the year prior; and to 26 million for primary care, a 24-fold spike from 400,000 in 2019. READ MORE

Increased Drug Costs Stifle Care Access, Medication Adherence for Millions

High drug costs served as a care access and medication adherence barrier for nearly 13 million adults before the pandemic, according to a new report from the Robert Wood Johnson Foundation and Urban Institute.

Particularly, the report said 13 million adults did not fill a prescription or delayed filling a prescription because of high cost. That includes 2.3 million Medicare beneficiaries and 3.8 million privately insured working-age adults who skipped necessary treatments due to high healthcare and drug costs.

The data, taken from the 2018-2019 Medical Expenditure Panel Survey, is from well before COVID-19 came ashore in the US and reshaped the way the nation views healthcare, the researchers acknowledged. Nevertheless, insights into cost-related care access and medication adherence barriers before the pandemic should shape the industry’s post-pandemic policymaking.

Over 3 percent of Medicare beneficiaries spent more than 10 percent of their family income on prescription drugs. For Medicare beneficiaries with unmet prescription drug needs, that figure is about 7 percent, meaning these patients spent a tenth of their family income on prescription drugs and still didn’t have all they clinically needed. READ MORE

Specialty Drugs Made Up More Than Half on 2020 Medicaid Spending

Specialty drugs accounted for 51.4 percent of the net cost in Medicaid and 1.3 percent of utilization in 2020, according to a Magellan Health trend report.

The Medicaid Pharmacy Trend Report looked at the evolving landscape of Medicaid, including an in-depth analysis of class and drug trends, forecasting, drugs in the pipeline, and pharmacy economics, all of which have developed even more from the events of the last two years.

Specialty drugs such as hepatitis C therapy, Mavyret, and Trikafta (a combination therapy for cystic fibrosis) represented the highest net dollar impact in their categories. And last year also saw an increased gross cost per claim and net cost per claim of 8.5 percent and 8.9 percent, respectively.

Top drug classes were similar to previous years, with HIV/AIDS and antipsychotics accounting for over 19.8 percent of total net drug spend. And the top five classes accounted for nearly 40 percent of total net spending. READ MORE

Artificial Intelligence Predict Cardiac Surgery Outcomes

Mayo Clinic researchers have shown that a novel artificial intelligence algorithm can predict long-term patient survival after cardiac surgery.

The research team found an algorithm that previously showed it could detect patients with reduced left ventricular ejection fraction could also predict long-term mortality after cardiac surgery, creating a valuable risk assessment tool for a patient considering surgery.

The retrospective study used data from 20,627 patients at Mayo Clinic in Rochester from 1993 to 2019. The patients underwent coronary artery bypass grafting, valve surgery, or both. Additionally, they had a left ventricular ejection fraction of greater than 35 percent.

The data indicated the probability of survival after five years was 86.2 percent for those with a normal screen versus 71.4 percent for patients with an abnormal screen. At ten years, the probability of survival was 68.2 percent and 45.1 percent for the two groups. READ MORE

Two Studies Highlight Physician Compensation Gaps

Physician compensation may hinge on your gender and where you practice, two studies published in the December 2021 edition of Health Affairs suggest.

One study analyzed data from over 80,000 full-time physicians across various settings, including academic medical centers and community sites, and a variety of specialties. It found that physicians labeled as female by sources such as the National Plan and provider Enumeration System, National Provider Identifier Registry, and the American Board of Medical Specialists earned about 25 percent less than their male counterparts over the course of a simulated 40-year career. That represented a $2 million difference over a physician’s career.

A separate study found physician compensation differences among physicians practicing in independent and hospital-owned practices. Researchers analyzed national survey data on physician practice ownership with data on physician income from 2014 through 2018. During that time, they found that hospital and health system ownership of physician practices increased by about 89 percent. At the same time, physician compensation for providers working in acquired practices was 0.8 percent lower, on average, compared to the income of independent physicians. The difference translated to an average of $2,987. READ MORE

Massachusetts Blue Incentivize Local Providers to Address Disparities

Blue Cross Blue Shield of Massachusetts (Blue Cross) is providing $25 million to local healthcare organizations to help reduce racial care disparities.

The Institute for Healthcare Improvement (IHI) will distribute the funding to practices and hospitals through grants. The funds will help recipients improve their equity efforts and offer financial incentives for addressing inequities in new contracts starting in 2023.

“We know these changes can’t be made overnight. Addressing deep-rooted inequities requires significant time, energy, and staff resources,” Andrew Dreyfus, president and chief executive officer of Blue Cross, stated.

Physician practices and hospitals can use the funding for various health equity practices, including improving their patient race and ethnicity data collection and increasing the number of focused interventions to improve clinical conditions. READ MORE