The Impact of Telemedicine Parity Requirements on Telehealth Utilization in the United States During the COVID-19 Pandemic

Abstract

Background: Research has shown a dramatic increase in telehealth utilization during the COVID-19 pandemic and marked socioeconomic disparities in telehealth utilization. However, previous studies have shown discrepant findings on the association between the state's telehealth payment parity laws and telehealth utilization, and dearth of differential impact studies by subgroups.

Methods: Using a nationally representative Household Pulse Survey from April 2021 to August 2022 and the logistic regression modeling, we estimated the impact of parity payment laws on overall, video, and phone telehealth utilization and related disparities by race and ethncity during the pandemic.

Results: We found that adults in parity states had 23% higher odds of telehealth utilization (odds ratio [OR] = 1.23; 95% confidence interval [CI], 1.14-1.33) and 124% higher odds of video telehealth utilization (OR = 2.24; 95% CI, 1.95-2.57) than their counterparts in nonparity states. In parity states, non-Hispanic White adults had 24% higher odds of telehealth utilization (OR = 1.24; 95% CI: 1.14, 1.35) and non-Hispanic Black adults had 31% higher odds of telehealth utilization (OR = 1.31; 95% CI: 1.03, 1.65), compared with those in nonparity states. For Hispanics, non-Hispanic Asians, and non-Hispanic other races, there was not a statistically significant effect of parity act on overall telehealth utilization.

Conclusions: Given inequalities in telehealth utilization, increased state policy efforts are needed to reduce access disparities during the ongoing pandemic and beyond.