Taking advantage of new telehealth flexibilities, this type of employer-provided coverage leaned in to provide hardworking Americans with access to the quality care they need and deserve
Washington, D.C. – March 17, 2022 – Nearly 180 million Americans have employer-provided health insurance coverage, and 40% of them are covered by a Consumer-Directed Health Plan (CDHP), which combine a high-deductible plan with a tax advantaged health savings account (HSA). As the COVID-19 pandemic impacted every family and community, health insurance providers called for new flexibilities that would permit these plans to cover more telehealth services – without a patient having to touch their deductible. A new study from AHIP demonstrates that the vast majority of CDHPs took advantage of the flexibilities that Congress permitted in 2020 and 2021, covering many physical and mental health care services on a pre-deductible basis.
“Throughout COVID-19, Americans embraced telehealth as a safe and convenient way to access high-quality care – and now many patients and doctors prefer telehealth for many care needs,” said Matt Eyles, AHIP President and CEO. “By making telehealth services more affordable and accessible, CDHPs are helping to improve the health and financial security of millions of hardworking American families. And with the bipartisan passage of the 2022 Consolidated Appropriations Act, Congress is extending the ability of for health insurance providers to build on this success story.”
The Internal Revenue Code limits the ability of CDHPs to cover items or services before an enrollee meets their deductible. But the enactment of the bipartisan Coronavirus Aid, Relief, and Economic Security (CARES) Act in May 2020 permitted new flexibilities for health insurance providers to find new ways to break down barriers to physical and mental health care. While this safe harbor expired at the end of 2021, Congress recently acted to provide a telehealth safe harbor from April through December 2022, allowing millions to continue to access affordable and convenient virtual care throughout that time period. AHIP applauds bipartisan legislation introduced by Reps. Michelle Steel (R-CA) and Susie Lee (D-NV) in the House and Sens. Steve Daines (R-MT) and Catherine Cortez Masto (D-NV) in the Senate (H.R. 5981/S. 1704) that would permanently extend the telehealth safe harbor.
Americans Embraced Telehealth for Primary Care and Behavioral Health
To learn more about how these flexibilities impacted American families, AHIP conducted a survey in February 2022 of health insurance providers in its membership. Insurance providers who responded together cover 105 million people.
AHIP supplemented these findings by analyzing medical claims of CDHP enrollees from July – December 2020 – the most recent timeframe for which these claims are available via the IBM® MarketScan® database. Key findings include:
- Americans with CDHPs had pre-deductible access to telehealth: The vast majority of CDHPs elected 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 commonly covered: Nearly any type of care that could be delivered via telehealth was available. Services most commonly covered included primary care (95%), mental health care (95%), chronic care (89%), and acute/urgent care (89%).
- Behavioral health care, as a category, was most frequently provided: An analysis of claims data shows that the most common types of services delivered via telehealth pre-deductible included primary care engagements such as evaluation 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 form of care most frequently accessed via telehealth pre-deductible.
- CDHPs covered telehealth services pre-deductible – no exceptions: Of the plans covering telehealth services pre-deductible, none of them excluded any services that could be safely delivered through telehealth.
- Patient’s adoption of telehealth varies by region: States with the highest number of telehealth claims far outpaced the states with the lowest number of telehealth claims.
“These findings are clear: Americans are using telehealth for physical and mental health care, and health insurance providers are delivering for them,” Eyles noted. “We will continue to engage with Congress to extend the use of telehealth to ensure that patients and consumers can continue to enjoy the improved affordability, access, and value it delivers.”
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About AHIP
AHIP is the national association whose members provide health care coverage, services, and solutions to hundreds of millions of Americans every day. We are committed to market-based solutions and public-private partnerships that make health care better and coverage more affordable and accessible for everyone. Visit www.ahip.org to learn how working together, we are Guiding Greater Health.