Cambridge, MA, June 23, 2022 — Following the substantial increase in the second quarter of 2020 (2020Q2), use of telemedicine decreased starting in 2020Q3 and stabilized in subsequent quarters. According to a new Workers Compensation Research Institute (WCRI) FlashReport, telemedicine’s share of evaluation and management (E&M) services was still higher at 3 percent in 2021Q1 as compared with 0.2 percent pre-pandemic, while the use of telemedicine for physical medicine became closer to the pre-pandemic level.

“Although COVID-19 cases in the U.S. have plateaued, it is commonly anticipated that the utilization of telemedicine will remain at levels higher than pre-pandemic,” said John Ruser, WCRI’s president and CEO. “Multiple legislative actions at the federal and state level are being debated in order to streamline the process of delivering medical services via telemedicine and regulate the reimbursement for telemedicine services. For these reasons, the utilization and prices of medical services delivered via telemedicine remain important measures to monitor in workers’ compensation.”

The FlashReport, Telemedicine: Patterns of Use and Reimbursement, 2020Q1–2021Q2, focuses on two types of medical services with the most prevalent use of telemedicine: E&M and physical medicine services. It investigates the patterns of telemedicine utilization among these services in workers’ compensation during the first five quarters of the pandemic (primarily March 2020–June 2021) across 28 states. It also examines the actual prices paid for the most frequent services delivered via telemedicine versus in person across the study states.

The following are among the study’s major findings:

• The use of telemedicine E&M and physical medicine services varied across study states. 
• Prices paid for E&M and physical medicine telemedicine services were similar to those for in-person services in the vast majority of states in 2020 and 2021 (January–June).
• The prevalence of telemedicine use was higher among workers with sprains and strains, averaging 8 percent among the study states for the 2020Q2 claims. For workers with fractures/lacerations/contusions, telemedicine use was lower at, on average, 5 percent. These numbers declined in 2020Q3 to 5 percent for sprains and strains patients and about 3 percent for patients with traumatic injuries, and remained at that level for the 2020Q4 claims.
• If a patient had the initial E&M visit via telemedicine, on average the majority of all E&M follow-up visits were provided as telemedicine for that patient during the first two quarters of care after injury.
• On average across study states, the time to initial E&M visit was similar for telemedicine services and in-person services—for example, for 2020Q2 claims, 6.0 days versus 5.8 days, respectively.
• Workers relying only on in-person visits had fewer visits on average during the first two quarters from injury date than workers who used only telemedicine services—4 visits versus 5 visits, respectively. Patients with a mix of telemedicine and in-person follow-up services had a significantly larger number of total visits than patients with either only telemedicine or only in-person services (7.0 visits for claims with initial telemedicine visits and 6.5 visits for claims with initial in-person visits).

This report is based on a sample of workers’ compensation claims for private sector workers and local public employees (e.g., police and firefighters) from 28 states. The states are Arizona, Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Nevada, New Jersey, New Mexico, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin. These study states represent 79 percent of the workers’ compensation benefits paid nationwide.

Olesya Fomenko and Rebecca Yang are the authors of the report, which is free for members and available to nonmembers for $35. To download a copy of the report, visit https://www.wcrinet.org/reports/telemedicine-patterns-of-use-and-reimbursement-2020q12021q2-a-wcri-flashreport. 

ABOUT WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Organized in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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