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The Role of Telehealth Payment Parity on Recommended Care and Emergency Department Service Utilization Among Workers With Chronic Conditions.

Publication ,  Journal Article
Zhang, Z; Bundorf, MK; Gong, Q; Trogdon, JG; Gilleskie, D; Sylvia, SY
Published in: Medical care
October 2025

State-level telehealth payment parity, requiring equal payment rates for telehealth and in-person visits, played an important role in ensuring access to telehealth services. The objective of our study is to evaluate how improved access, driven by telehealth payment parity, affected the utilization of disease-specific recommended care management services and emergency department (ED) services among insured patients with chronic conditions.We adopted a 2-way fixed-effect difference-in-differences approach using the Merative Commercial Claims and Encounters database from 2019 to 2021.We focused on insured workers aged 19-64 with pre-existing mental health disorders or cardiometabolic risks (CMRs).Outcomes include psychotherapy for mental health disorders, preventive care counseling for CMRs, and ED visits.Telehealth payment parity was associated with a significant increase in the number of psychotherapy visits and tele-psychotherapy by 0.221 visits (95% CI: 0.050-0.391) and 0.411 visits (95% CI: 0.003-0.818) per patient per quarter, respectively. The regulation significantly reduced E.D. visits among individuals with mental health disorders by 0.003 visits (95% CI: -0.007 to 0.000) per quarter, a 25% relative decrease compared with the control at preperiod. However, payment parity was not statistically associated with increasing preventive care visits and lowering ED visits among individuals with CMRs.Telehealth payment parity has effectively promoted the adoption of psychotherapy and reduced ED visits among insured workers with mental health disorders. However, it has not significantly improved the uptake of preventive care counseling for individuals with CMRs.

Duke Scholars

Published In

Medical care

DOI

EISSN

1537-1948

ISSN

0025-7079

Publication Date

October 2025

Volume

63

Issue

10

Start / End Page

779 / 786

Related Subject Headings

  • Young Adult
  • United States
  • Telemedicine
  • Patient Acceptance of Health Care
  • Middle Aged
  • Mental Disorders
  • Male
  • Humans
  • Health Services Accessibility
  • Health Policy & Services
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Zhang, Z., Bundorf, M. K., Gong, Q., Trogdon, J. G., Gilleskie, D., & Sylvia, S. Y. (2025). The Role of Telehealth Payment Parity on Recommended Care and Emergency Department Service Utilization Among Workers With Chronic Conditions. Medical Care, 63(10), 779–786. https://doi.org/10.1097/mlr.0000000000002185
Zhang, Zhang, M Kate Bundorf, Qing Gong, Justin G. Trogdon, Donna Gilleskie, and Sean Y. Sylvia. “The Role of Telehealth Payment Parity on Recommended Care and Emergency Department Service Utilization Among Workers With Chronic Conditions.Medical Care 63, no. 10 (October 2025): 779–86. https://doi.org/10.1097/mlr.0000000000002185.
Zhang Z, Bundorf MK, Gong Q, Trogdon JG, Gilleskie D, Sylvia SY. The Role of Telehealth Payment Parity on Recommended Care and Emergency Department Service Utilization Among Workers With Chronic Conditions. Medical care. 2025 Oct;63(10):779–86.
Zhang, Zhang, et al. “The Role of Telehealth Payment Parity on Recommended Care and Emergency Department Service Utilization Among Workers With Chronic Conditions.Medical Care, vol. 63, no. 10, Oct. 2025, pp. 779–86. Epmc, doi:10.1097/mlr.0000000000002185.
Zhang Z, Bundorf MK, Gong Q, Trogdon JG, Gilleskie D, Sylvia SY. The Role of Telehealth Payment Parity on Recommended Care and Emergency Department Service Utilization Among Workers With Chronic Conditions. Medical care. 2025 Oct;63(10):779–786.

Published In

Medical care

DOI

EISSN

1537-1948

ISSN

0025-7079

Publication Date

October 2025

Volume

63

Issue

10

Start / End Page

779 / 786

Related Subject Headings

  • Young Adult
  • United States
  • Telemedicine
  • Patient Acceptance of Health Care
  • Middle Aged
  • Mental Disorders
  • Male
  • Humans
  • Health Services Accessibility
  • Health Policy & Services