Washington, DC – March 17, 2022 – Nearly 180 million Americans have employer-provided health insurance coverage, and 40% of them are covered by a consumer-driven health plan (CDHP), which combines a high-deductible plan with a tax-efficient Health Savings Account (HSA). As the COVID-19 pandemic has touched every family and every community, health insurance providers have asked for new flexibilities that would allow these plans to cover more telehealth services – without a patient having to touch his frankness. A new study of the AHIP demonstrates that the vast majority of CDHPs took advantage of the flexibilities authorized by Congress in 2020 and 2021, covering many physical and mental health care services on a pre-deductible basis.
“Throughout COVID-19, Americans have embraced telehealth as a safe and convenient way to access high-quality care — and now many patients and physicians prefer telehealth for many care needs,” said said Matt Eyles, President and CEO of AHIP. “By making telehealth services more affordable and accessible, CDHPs are helping to improve the health and financial security of millions of hard-working American families. And with the bipartisan passage of the Consolidated Appropriations Act of 2022, Congress is expanding the ability of health insurance providers to build on that success.
The Internal Revenue Code limits the ability of CDHPs to cover items or services before a registrant reaches their deductible. But the enactment of the bipartisan Coronavirus Aid, Relief, and Economic Security (CARES) Act in May 2020 gave health insurance providers new flexibilities to find new ways to remove barriers to physical and mental health care. While this Safe Harbor expired at the end of 2021, Congress recently acted to provide a Safe Harbor for telehealth from April to December 2022, allowing millions of people to continue to access affordable virtual care. and practices throughout this period. AHIP applauds the bipartisan legislation introduced by Representatives Michelle Steel (R-CA) and Susie Lee (D-NV) in the House and the Senses. Steve Daines (R-MT) and Catherine Cortez Masto (D-NV) in the Senate (HR 5981/S. 1704) that would permanently expand the telehealth safe harbor.
Americans have embraced telehealth for primary care and behavioral health
To learn more about the impact of these flexibilities on American families, AHIP conducted a survey in February 2022 of health insurance providers among its members. The insurers who responded together cover 105 million people.
AHIP supplemented these results by analyzing the medical claims of CDHP enrollees from July to December 2020 – the most recent period for which these claims are available through IBM.® Market analysis® database. Key findings include:
- Americans with CDHP had pre-deductible access to telehealth: The vast majority of CDHPs chose to cover telehealth services on a pre-deductible basis (83% of plans offering fully insured products, 81% of plans offering self-insured products).
- Routine care and mental health care were most often covered: Almost every type of care that could be delivered via telehealth was available. The most commonly covered services included primary care (95%), mental health care (95%), chronic care (89%) and acute/urgent care (89%).
- Behavioral health care, as a category, was most often provided: An analysis of claims data shows that the most common types of services provided via telehealth pre-franchise included primary care assignments such as assessment and management visits, psychotherapy, speech and language, therapy , medication management and medical nutrition therapy. When looking at categories of care, behavioral health care services together were the most frequently accessed form of care via pre-franchise telehealth.
- The CDHPs covered pre-deductible telehealth services – without exception: Of the plans covering pre-deductible telehealth services, none excluded services that could be delivered safely through telehealth.
- Patient adoption of telehealth varies by region: The states with the highest number of telehealth requests significantly outpaced the states with the lowest number of telehealth requests.
“These findings are clear: Americans are using telehealth for physical and mental health care, and health insurance providers are providing it to them,” Eyles noted. “We will continue to work with Congress to expand the use of telehealth to ensure that patients and consumers can continue to benefit from the improved accessibility, access, and value it offers.”