UnitedHealthcare Sees 2.5K% Increase in Telehealth Usage

The payer's 2021 data show a massive increase in telehealth use when compared with pre-pandemic levels.

UnitedHealthcare Inc. members logged more than 28 million virtual care visits in 2021, a 2,500% increase over pre-pandemic usage, the payer says.

"While the COVID-19 pandemic triggered an unprecedented spike in the number of virtual care visits, we are seeing that telehealth has staying power even as many people have returned to in-person appointments," UnitedHealthcare CMO Donna O'Shea, MD, tells HealthLeaders.

"Virtual care visits in 2021 by UnitedHealthcare members approximately matched the total for 2020, with continued significant use of telehealth so far in 2022."    

UHC data show that:

• Members used virtual care 28 million times in 2021, a 2,500% increase from the pre-pandemic baseline and steady from 2020.
   
• Local providers delivered 95% of those virtual care visits.
    
• Half (50%) of virtual visits -- 14 million -- were for behavioral health, and 63% of all behavioral health visits were done virtually, up from 1.5% pre-pandemic.  
   
• The share of virtual care users aged 25 to 44 grew from 36% in 2020 to 38%.
   
• The share of virtual care users among women grew from 62% in 2020 to 64%.

In an email exchange with HealthLeaders, O'Shea talked about the new data on telehealth usage, and what it reveals about the burgeoning sector.

HL: What do your numbers say about the status of telehealth today in the USA?

O'Shea: While the COVID-19 pandemic triggered an unprecedented spike in the number of virtual care visits (a 2,500% increase compared to pre-pandemic levels), we are seeing that telehealth has staying power even as many people have returned to in-person appointments. Virtual care visits in 2021 by UnitedHealthcare members approximately matched the total for 2020, with continued significant use of telehealth so far in 2022.  

Virtual care has expanded from delivering care to people who are sick to also focusing on preventing and detecting disease and helping people manage chronic conditions. Through better insights and digital tools, we are seeing virtual care enable the ability to flag gaps in care, prevent complications and avoid unnecessary hospitalizations – all of which can help improve health outcomes and curb costs. As more consumers and care professionals move to a digital mindset, we will continue to expand the use of virtual care, including to help people access primary, behavioral and specialty services such as dental, hearing and physical therapy support. 

Importantly, virtual care for behavioral health issues has come in to its own since the start of the pandemic. Many people recognize virtual services for mental health can be as good or better than in-person services, bringing added privacy and convenience. In fact, 66% of our behavioral health claims were virtual in 2021, up from 1.5% in 2019.

HL: What are these numbers telling payers?

O'Shea: The on-going, widespread use of virtual care is an indication that consumers and care providers have embraced this technology. We know that virtual care can help make care more affordable and accessible, especially during nights or weekends and for the 20% of Americans in rural areas. In fact, industry estimates show savings of between $19 and $120 per virtual visit compared to an in-person appointment.

Importantly, many minor ailments can be addressed via a virtual urgent care visit, rather than in the emergency room. A UnitedHealthcare analysis found that about 25% of emergency room visits involve conditions that could appropriately be addressed with a virtual urgent care visit. UnitedHealthcare members using 24/7 Virtual Visits generally pay less than $49 per appointment compared to an average of $740 for an emergency room visit for a similar low-severity condition. These virtual visits are designed to help provide an alternative way to access care when clinics and urgent care facilities may be closed or inconvenient to visit.

Based on the trends we are seeing, we expect telehealth to continue to play an important role in helping people access urgent, preventive, routine and chronic condition care.

HL: We have seen some indications that telehealth use has been tapering off. Should payers do something, i.e. offer incentives to enrollees, etc., to maintain telehealth use?

O'Shea: To support the on-going use of virtual care, it will be important continue certain practices even after the COVID-19 pandemic end. For instance, UnitedHealthcare has supported our network physicians in this regard by modernizing our reimbursement policies to compensate care professionals for virtual visits, while assisting some network health care providers to adopt the information technology infrastructure to virtually connect with patients.

More specifically, a UnitedHealthcare reimbursement policy enables certain primary care, specialist care, and therapy services to be administered virtually as an alternative to in-person visits. Due in part to this policy that will continue even after the COVID-19 public health emergency ends, over 95% of virtual care visits among our members are being conducted with local care providers.

To drive further adoption, we are working with employers to offer employees incentives, such as a financial reward, to jump-start their interest in using virtual care. For example, some employers may consider offering $5 prepaid gift cards to employees for completing a virtual visit registration*. According to one study, that small incentive helped generate a 40% increase in sign-ups compared to a control group.[1]   

HL: How does UHC see telehealth growing, both in use and in specialty areas, in the next five years?

O'Shea: We believe the future of virtual care will feature a hybrid model, seamlessly connecting members to care via telehealth and in-person services, when needed. This is already coming to fruition through new virtual-first health plans, which offer an integrated approach to provide care virtually and in-person to make care more simple, convenient, and reduce costs.

For instance, our new NavigateNOW plan represents a transformational step that helps people seamlessly move between virtual and in-person care. People enrolled in this plan are supported by a personalized care team that not only delivers virtual primary, urgent, and behavioral health services at the touch of a button, but also offers a concierge service to make it as easy as possible to schedule follow-up appointments with Optum providers and other health care professionals.

The result: simple, convenient, and more affordable health care, including lowering plan premiums by approximately 15%. Members enjoy $0 for virtual and in-person primary care and behavioral health visits, virtual urgent care and most generic medications, with unlimited chat, online scheduling and on-demand, same-day appointments

[1] UnitedHealthcare internal analysis of more than 90,000 small employers spanning small businesses, key accounts, national accounts and public sector employers, 2020