Behavioral is the only segment of the health care sector where telehealth is a substitute for in-person care and it drove the majority of telehealth visits during 2021.
Those are two of the key takeaways from a new report on the place of telehealth with health care from Trilliant Health, a Brentwood, Tennessee-based predictive analytics company focused on health care.
Using economic parlance, the report claims that “telehealth is only a ‘substitute good’ for behavioral health.” A substitute good is economist parlance for something that is effectively the same in performance, the occasion of use and distribution.
The report applies the laws of economics to interrogate whether or not telehealth is the future of health care and how far its impact has gone following the onset of the coronavirus pandemic. In short, it paints a stark picture compared to many of the assessments from other thought leaders in the health care space.
It starts by highlighting the relatively limited reach of telehealth: “Only 25.6% of Americans used telehealth during the two years of the pandemic,” the report states.
“Said another way, investments in the telehealth market have been made on the thesis that telehealth is preferred among most Americans,” Sanjula Jain, senior vice president of market strategy and chief research officer for Trilliant Health, wrote in the report’s introduction. “But the reality is that all these efforts are being dedicated to only a subset of the U.S. population.”
However, that subset appears to largely be made up of patients seeking and receiving behavioral health services via telehealth.
Before the pandemic, 98% of patients received care in an in-person-only format. In 2020, that number dipped to about 71% and increased to about 80% in 2021.
Before and after the onset of the pandemic, behavioral health services made up the greatest share of telehealth visits — 47.5% of all telehealth visits between April 2019 and November 2021.
After the onset of the pandemic, behavioral health’s share grew rapidly. From March 2020 to November 2021, behavioral health telehealth utilization increased among all telehealth visits by 55%, the report states.
The increase in the share of telehealth by the behavioral health industry across the whole of health care is also boosted by a decline in telehealth utilization across health care. Monthly utilization has dropped to a pandemic-era low of about 6.9 million visits in November 2021 compared to about 16.9 million in April 2020, a 59% reduction.
On average in 2021, 57.9% of telehealth visits were attributed to behavioral health diagnoses. The report also states that most Americans prefer in-person care, which is demonstrated in other data.